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Liu D, Zhang Y, Liang R, Lei J, Huang K, Hu Y, Fang L, Feng L, Shan G, Wang M, Ding Y, Gao Q, Yang T. Development and validation of a COVID-19 vaccination prediction model based on self-reporting results in Chinese older adults from September 2022 to November 2022: A nationwide cross-sectional study. Hum Vaccin Immunother 2024; 20:2382502. [PMID: 39081126 DOI: 10.1080/21645515.2024.2382502] [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: 04/23/2024] [Revised: 07/08/2024] [Accepted: 07/17/2024] [Indexed: 08/04/2024] Open
Abstract
It was common to see that older adults were reluctant to be vaccinated for coronavirus disease 2019 (COVID-19) in China. There is a lack of practical prediction models to guide COVID-19 vaccination program. A nationwide, self-reported, cross-sectional survey was conducted from September 2022 to November 2022, including people aged 60 years or older. Stratified random sampling was used to divide the dataset into derivation, validation, and test datasets at a ratio of 6:2:2. Least absolute shrinkage and selection operator and multivariable logistic regression were used for variable screening and model construction. Discrimination and calibration were assessed primarily by area under the receiver operating characteristic curve (AUC) and calibration curve. A total of 35057 samples (53.65% males and mean age of 69.64 ± 7.24 years) were finally selected, which constitutes 93.73% of the valid samples. From 33 potential predictors, 19 variables were screened and included in the multivariable logistic regression model. The mean AUC in the validation dataset was 0.802, with sensitivity, specificity, and accuracy of 0.732, 0.718 and 0.729 respectively, which were similar to the parameters in the test dataset of 0.755, 0.715 and 0.720, respectively, and the mean AUC in the test dataset was 0.815. There were no significant differences between the model predicted values and the actual observed values for calibration in these groups. The prediction model based on self-reported characteristics of older adults was developed that could be useful for predicting the willingness for COVID-19 vaccines, as well as providing recommendations in improving vaccine acceptance.
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Affiliation(s)
- Dong Liu
- Capital Medical University, Beijing, China
- National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Yushi Zhang
- Peking Union Medical College/Chinese Academy of Medical Sciences, China-Japan Friendship Hospital, Beijing, China
| | - Rui Liang
- National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Beijing University of Chinese Medicine China-Japan Friendship School of Clinical Medicine, Beijing, China
| | - Jieping Lei
- Data and Project Management Unit, Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China
| | - Ke Huang
- National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Yaoda Hu
- Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Liwen Fang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Luzhao Feng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guangliang Shan
- Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Min Wang
- Department of Rheumatology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Clinical Immunology Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuanyuan Ding
- The secretariat, Chinese Association of Geriatric Research, Beijing, China
| | - Qian Gao
- National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Ting Yang
- National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
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2
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Darling TL, Harastani HH, Joshi A, Bricker TL, Soudani N, Seehra K, Hassan AO, Diamond MS, Boon ACM. Mucosal immunization with ChAd-SARS-CoV-2-S prevents sequential transmission of SARS-CoV-2 to unvaccinated hamsters. SCIENCE ADVANCES 2024; 10:eadp1290. [PMID: 39083604 PMCID: PMC11290484 DOI: 10.1126/sciadv.adp1290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 06/25/2024] [Indexed: 08/02/2024]
Abstract
COVID-19 vaccines have successfully reduced severe disease and death after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Nonetheless, COVID-19 vaccines are variably effective in preventing transmission and symptomatic SARS-CoV-2 infection. Here, we evaluated the impact of mucosal or intramuscular vaccine immunization on airborne infection and transmission of SARS-CoV-2 in Syrian hamsters. Immunization of the primary contact hamsters with a mucosal chimpanzee adenoviral-vectored vaccine (ChAd-CoV-2-S), but not intramuscular messenger RNA (mRNA) vaccine, reduced infectious virus titers ~100-fold and 100,000-fold in the upper and lower respiratory tract of the primary contact hamster following SARS-CoV-2 exposure. This reduction in virus titer in the mucosal immunized contact animals was sufficient to eliminate subsequent transmission to vaccinated and unvaccinated hamsters. In contrast, sequential transmission occurred after systemic immunization with the mRNA vaccine. Thus, immunization with a mucosal COVID-19 vaccine protects against cycles of respiratory transmission of SARS-CoV-2 and can potentially limit the community spread of the virus.
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Affiliation(s)
- Tamarand L. Darling
- Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Houda H. Harastani
- Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Astha Joshi
- Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Traci L. Bricker
- Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Nadia Soudani
- Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Kuljeet Seehra
- Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Ahmed O. Hassan
- Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Michael S. Diamond
- Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Adrianus C. M. Boon
- Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO 63110, USA
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3
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Shi DS, Rinsky JL, McDonald E, Shah MM, Groenewold MR, de Perio MA, Feldstein LR, Saydah S, Haynes JM, Spencer BR, Stramer SL, McCullough M, Jones JM, Chiu SK. Distribution of COVID-19 mitigation measures by industry and work arrangement-US blood donors, May 2021-December 2021. Am J Ind Med 2024; 67:764-771. [PMID: 38856006 PMCID: PMC11265519 DOI: 10.1002/ajim.23626] [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: 03/19/2024] [Revised: 04/30/2024] [Accepted: 05/29/2024] [Indexed: 06/11/2024]
Abstract
OBJECTIVE To describe coronavirus disease 2019 (COVID-19) mitigation measures in workplaces of employed US blood donors by industry and work arrangement. METHODS During May-December 2021, blood donors responded to a survey; we describe the distribution of reported workplace mitigation measures by industry and work arrangement, organized using the hierarchy of controls. RESULTS Of 53,433 respondents representing 21 industries, ventilation upgrades were reported by 4%-38% of respondents (overall: 20%); telework access ranged from 14%-80% (53% overall). Requiring masks (overall: 84%; range: 40%-94%), physical distancing (77%; 51%-86%), paid leave for illness (70%; 38%-87%), and encouraging vaccination (61%; 33%-80%) were common. Independent workers reported fewer mitigation measures than those in traditional employment settings. CONCLUSIONS Mitigation measures varied by industry and work arrangement. Some mitigation measures may be challenging to implement or irrelevant in certain industries, supporting the idea that mitigation is not a one-size-fits-all strategy. POLICY IMPLICATIONS Tailored strategies to mitigate workplace risks of disease transmission are vital. Strategies should rely on effective methods for identifying workplace controls (e.g., through the hierarchy of controls) and account for industry-specific characteristics and workplace environments.
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Affiliation(s)
- Dallas S. Shi
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH
| | - Jessica L. Rinsky
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH
| | - Emily McDonald
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH
| | - Melisa M. Shah
- Coronaviruses and Other Respiratory Viruses Division, National Center for Immunizations and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA
| | - Matthew R. Groenewold
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH
| | - Marie A. de Perio
- Office of the Director, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH
| | - Leora R. Feldstein
- Coronaviruses and Other Respiratory Viruses Division, National Center for Immunizations and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA
| | - Sharon Saydah
- Coronaviruses and Other Respiratory Viruses Division, National Center for Immunizations and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA
| | - James M. Haynes
- American Red Cross, Scientific Affairs, Dedham, MA and Rockville, MD
| | - Bryan R. Spencer
- American Red Cross, Scientific Affairs, Dedham, MA and Rockville, MD
| | - Susan L. Stramer
- American Red Cross, Scientific Affairs, Dedham, MA and Rockville, MD
| | - Matthew McCullough
- Coronaviruses and Other Respiratory Viruses Division, National Center for Immunizations and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA
| | - Jefferson M. Jones
- Coronaviruses and Other Respiratory Viruses Division, National Center for Immunizations and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA
| | - Sophia K. Chiu
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH
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4
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Solberg RB, Fretheim A, Elgersma IH, Fagernes M, Iversen BG, Hemkens LG, Rose CJ, Elstrøm P. Personal protective effect of wearing surgical face masks in public spaces on self-reported respiratory symptoms in adults: pragmatic randomised superiority trial. BMJ 2024; 386:e078918. [PMID: 39048132 PMCID: PMC11267995 DOI: 10.1136/bmj-2023-078918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/29/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVE To evaluate the personal protective effects of wearing versus not wearing surgical face masks in public spaces on self-reported respiratory symptoms over a 14 day period. DESIGN Pragmatic randomised superiority trial. SETTING Norway. PARTICIPANTS 4647 adults aged ≥18 years: 2371 were assigned to the intervention arm and 2276 to the control arm. INTERVENTIONS Participants in the intervention arm were assigned to wear a surgical face mask in public spaces (eg, shopping centres, streets, public transport) over a 14 day period (mask wearing at home or work was not mentioned). Participants in the control arm were assigned to not wear a surgical face mask in public places. MAIN OUTCOME MEASURES The primary outcome was self-reported respiratory symptoms consistent with a respiratory infection. Secondary outcomes included self-reported and registered covid-19 infection. RESULTS Between 10 February 2023 and 27 April 2023, 4647 participants were randomised of whom 4575 (2788 women (60.9%); mean age 51.0 (standard deviation 15.0) years) were included in the intention-to-treat analysis: 2313 (50.6%) in the intervention arm and 2262 (49.4%) in the control arm. 163 events (8.9%) of self-reported symptoms consistent with respiratory infection were reported in the intervention arm and 239 (12.2%) in the control arm. The marginal odds ratio was 0.71 (95% confidence interval (CI) 0.58 to 0.87; P=0.001) favouring the face mask intervention. The absolute risk difference was -3.2% (95% CI -5.2% to -1.3%; P<0.001). No statistically significant effect was found on self- reported (marginal odds ratio 1.07, 95% CI 0.58 to 1.98; P=0.82) or registered covid-19 infection (effect estimate and 95% CI not estimable owing to lack of events in the intervention arm). CONCLUSION Wearing a surgical face mask in public spaces over 14 days reduces the risk of self-reported symptoms consistent with a respiratory infection, compared with not wearing a surgical face mask. TRIAL REGISTRATION ClinicalTrials.gov NCT05690516.
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Affiliation(s)
- Runar Barstad Solberg
- Centre for Epidemic Interventions Research (CEIR), Norwegian Institute of Public Health, Oslo, Norway
| | - Atle Fretheim
- Centre for Epidemic Interventions Research (CEIR), Norwegian Institute of Public Health, Oslo, Norway
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Ingeborg Hess Elgersma
- Centre for Epidemic Interventions Research (CEIR), Norwegian Institute of Public Health, Oslo, Norway
| | - Mette Fagernes
- Division of Infection Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Bjørn Gunnar Iversen
- Division of Infection Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Lars G Hemkens
- Pragmatic Evidence Lab, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), Basel, Switzerland
- Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA
| | - Christopher James Rose
- Centre for Epidemic Interventions Research (CEIR), Norwegian Institute of Public Health, Oslo, Norway
- Cluster for Reviews and Health Technology Assessments, Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Petter Elstrøm
- Centre for Epidemic Interventions Research (CEIR), Norwegian Institute of Public Health, Oslo, Norway
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5
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Badahdah AM, Viskupič F, Wiltse DL. The Influence of Disagreements over COVID-19 Preventive Measures on Stress and Sleep Quality. Psychol Rep 2024:332941241266185. [PMID: 39045771 DOI: 10.1177/00332941241266185] [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: 07/25/2024]
Abstract
In this paper we reported the rate of disagreements and their effect on stress levels and sleep quality. Data was collected from 573 South Dakota residents. We estimated two ordinary least squares regressions using stress and sleep quality due to COVID-19 as outcome variables. A high percentage (62.1%) of the participants reported disagreements over COVID-19 with friends and family members. Disagreements over COVID-19 were associated with a higher level of stress (β = 1.001, p = .000) and a lower level of sleep quality (β = -.431, p = .039). The results of this study should serve as a reminder to researchers to consider the impact of interpersonal conflict over public health measures with family and friends on mental health.
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Affiliation(s)
- Abdallah M Badahdah
- School of Psychology, Sociology and Rural Studies, Sociology Program, South Dakota State University, Brookings, SD, USA
| | - Filip Viskupič
- School of American and Global Studies, Department of Political Science, South Dakota State University, Brookings, SD, USA
| | - David L Wiltse
- School of American and Global Studies, Department of Political Science, South Dakota State University, Brookings, SD, USA
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6
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Klimek P, Ledebur K, Thurner S. Epidemic modelling suggests that in specific circumstances masks may become more effective when fewer contacts wear them. COMMUNICATIONS MEDICINE 2024; 4:134. [PMID: 38971886 PMCID: PMC11227579 DOI: 10.1038/s43856-024-00561-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 06/25/2024] [Indexed: 07/08/2024] Open
Abstract
BACKGROUND The effectiveness of non-pharmaceutical interventions to control the spread of SARS-CoV-2 depends on many contextual factors, including adherence. Conventional wisdom holds that the effectiveness of protective behaviours, such as wearing masks, increases with the number of people who adopt them. Here we show in a simulation study that this is not always true. METHODS We use a parsimonious network model based on the well-established empirical facts that adherence to such interventions wanes over time and that individuals tend to align their adoption strategies with their close social ties (homophily). RESULTS When these assumptions are combined, a broad dynamic regime emerges in which the individual-level reduction in infection risk for those adopting protective behaviour increases as adherence to protective behaviour decreases. For instance, at 10 % coverage, we find that adopters face nearly a 30 % lower infection risk than at 60 % coverage. Based on surgical mask effectiveness estimates, the relative risk reduction for masked individuals ranges from 5 % to 15 %, or a factor of three. This small coverage effect occurs when the outbreak is over before the pathogen is able to invade small but closely knit groups of individuals who protect themselves. CONCLUSIONS Our results confirm that lower coverage reduces protection at the population level while contradicting the common belief that masking becomes ineffective at the individual level as more people drop their masks.
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Affiliation(s)
- Peter Klimek
- Section for Science of Complex Systems, Medical University of Vienna, Vienna, Austria.
- Complexity Science Hub Vienna, Vienna, Austria.
- Supply Chain Intelligence Institute Austria, Vienna, Austria.
- Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Katharina Ledebur
- Section for Science of Complex Systems, Medical University of Vienna, Vienna, Austria
- Complexity Science Hub Vienna, Vienna, Austria
| | - Stefan Thurner
- Section for Science of Complex Systems, Medical University of Vienna, Vienna, Austria
- Complexity Science Hub Vienna, Vienna, Austria
- Santa Fe Institute, Santa Fe, NM, USA
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7
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Ruhm CJ. US State Restrictions and Excess COVID-19 Pandemic Deaths. JAMA HEALTH FORUM 2024; 5:e242006. [PMID: 39058508 PMCID: PMC11282449 DOI: 10.1001/jamahealthforum.2024.2006] [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: 12/15/2023] [Accepted: 05/21/2024] [Indexed: 07/28/2024] Open
Abstract
Importance Despite considerable prior research, it remains unclear whether and by how much state COVID-19-related restrictions affected the number of pandemic deaths in the US. Objective To determine how state restrictions were associated with excess COVID-19 deaths over a 2-year analysis period. Design, Setting, and Participants This was a cross-sectional study using state-level mortality and population data from the US Centers for Disease Control and Prevention for 2020 to 2022 compared with baseline data for 2017 to 2019. Data included the total US population, with separate estimates for younger than 45 years, 45 to 64 years, 65 to 84 years, and 85 years or older used to construct age-standardized measures. Age-standardized excess mortality rates and ratios for July 2020 to June 2022 were calculated and compared with prepandemic baseline rates. Excess death rates and ratios were then regressed on single or multiple restrictions, while controlling for excess death rates or ratios, from March 2020 to June 2020. Estimated values of the dependent variables were calculated for packages of weak vs strong state restrictions. Behavioral changes were investigated as a potential mechanism for the overall effects. Data analyses were performed from October 1, 2023, to June 13, 2024. Exposures Age and cause of death. Main Outcomes Excess deaths, age-standardized excess death rates per 100 000, and excess death ratios. Results Mask requirements and vaccine mandates were negatively associated with excess deaths, prohibitions on vaccine or mask mandates were positively associated with death rates, and activity limitations were mostly not associated with death rates. If all states had imposed restrictions similar to those used in the 10 most restrictive states, excess deaths would have been an estimated 10% to 21% lower than the 1.18 million that actually occurred during the 2-year analysis period; conversely, the estimates suggest counterfactual increases of 13% to 17% if all states had restrictions similar to those in the 10 least-restrictive states. The estimated strong vs weak state restriction difference was 271 000 to 447 000 deaths, with behavior changes associated with 49% to 79% of the overall disparity. Conclusions and Relevance This cross-sectional study indicates that stringent COVID-19 restrictions, as a group, were associated with substantial decreases in pandemic mortality, with behavior changes plausibly serving as an important explanatory mechanism. These findings do not support the views that COVID-19 restrictions were ineffective. However, not all restrictions were equally effective; some, such as school closings, likely provided minimal benefit while imposing substantial cost.
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Affiliation(s)
- Christopher J. Ruhm
- Frank Batten School of Leadership and Public Policy, University of Virginia, Charlottesville
- National Bureau of Economic Research, Cambridge, Massachusetts
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8
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Shen Z, Li Q, Wu J, Zhu D, Bai J, Ren R, Zhang J, Li Y, Wang M, Gu J, Li Y, Dong W, Wang H, Sun T, Yang F, Zhou X, Yang J, Tarimo CS, Ma M, Feng Y, Miao Y. Dynamic evolution of COVID-19 vaccine hesitancy over 2021-2023 among Chinese population: Repeated nationwide cross-sectional study. J Med Virol 2024; 96:e29800. [PMID: 39014958 DOI: 10.1002/jmv.29800] [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: 04/22/2024] [Revised: 06/29/2024] [Accepted: 07/04/2024] [Indexed: 07/18/2024]
Abstract
Globally, the rollout of COVID-19 vaccine had been faced with a significant barrier in the form of vaccine hesitancy. This study adopts a multi-stage perspective to explore the prevalence and determinants of COVID-19 vaccine hesitancy, focusing on their dynamic evolutionary features. Guided by the integrated framework of the 3Cs model (complacency, confidence, and convenience) and the EAH model (environmental, agent, and host), this study conducted three repeated national cross-sectional surveys. These surveys carried out from July 2021 to February 2023 across mainland China, targeted individuals aged 18 and older. They were strategically timed to coincide with three critical vaccination phases: universal coverage (stage 1), partial coverage (stage 2), and key population coverage (stage 3). From 2021 to 2023, the surveys examined sample sizes of 29 925, 6659, and 5407, respectively. The COVID-19 vaccine hesitation rates increased from 8.39% in 2021 to 29.72% in 2023. Urban residency, chronic condition, and low trust in vaccine developer contributed to significant COVID-19 vaccine hesitancy across the pandemic. Negative correlations between the intensity of vaccination policies and vaccine hesitancy, and positive correlations between vaccine hesitancy and long COVID, were confirmed. This study provides insights for designing future effective vaccination programs for emerging vaccine-preventable infectious X diseases.
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Affiliation(s)
- Zhanlei Shen
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Quanman Li
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Jian Wu
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Dongfang Zhu
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Junwen Bai
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Ruizhe Ren
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Jingbao Zhang
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Yi Li
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Meiyun Wang
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan, China
| | - Jianqin Gu
- School of Medicine, Southern University of Science and Technology, Guangdong, China
| | - Yinfei Li
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan, China
| | - Wenyong Dong
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan, China
| | - Haipeng Wang
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Tao Sun
- Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Fan Yang
- School of Public Health, Fudan University, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Xue Zhou
- College of Health Management, Mudanjiang Medical University, Mudanjiang, Heilongjiang, China
| | - Jian Yang
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Clifford Silver Tarimo
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Mingze Ma
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Yifei Feng
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Yudong Miao
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
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9
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Fumagalli R. Please wear a mask: a systematic case for mask wearing mandates. JOURNAL OF MEDICAL ETHICS 2024; 50:501-510. [PMID: 36810325 PMCID: PMC11228218 DOI: 10.1136/jme-2022-108736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/15/2023] [Indexed: 06/18/2023]
Abstract
This paper combines considerations from ethics, medicine and public health policy to articulate and defend a systematic case for mask wearing mandates (MWM). The paper argues for two main claims of general interest in favour of MWM. First, MWM provide a more effective, just and fair way to tackle the ongoing COVID-19 pandemic than policy alternatives such as laissez-faire approaches, mask wearing recommendations and physical distancing measures. And second, the proffered objections against MWM may justify some exemptions for specific categories of individuals, but do not cast doubt on the justifiability of these mandates. Hence, unless some novel decisive objections are put forward against MWM, governments should adopt MWM.
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Affiliation(s)
- Roberto Fumagalli
- Political Economy, King's College London, London, UK
- Philosophy, The London School of Economics and Political Science, London, UK
- Behavioral Ethics Lab, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Lv D, Xie X, Yang Q, Chen Z, Liu G, Peng W, Wang R, Huang H, Chen J, Wu J. Clinical characteristics and outcomes of hospitalized kidney transplant recipients with COVID-19 infection in China during the Omicron wave: a single-center cohort study. J Zhejiang Univ Sci B 2024; 25:529-540. [PMID: 38910497 PMCID: PMC11199089 DOI: 10.1631/jzus.b2300538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/22/2023] [Indexed: 06/25/2024]
Abstract
BACKGROUND: Following the short-term outbreak of coronavirus disease 2019 (COVID-19) in December 2022 in China, clinical data on kidney transplant recipients (KTRs) with COVID-19 are lacking. METHODS: We conducted a single-center retrospective study to describe the clinical features, complications, and mortality rates of hospitalized KTRs infected with COVID-19 between Dec. 16, 2022 and Jan. 31, 2023. The patients were followed up until Mar. 31, 2023. RESULTS: A total of 324 KTRs with COVID-19 were included. The median age was 49 years. The median time between the onset of symptoms and admission was 13 d. Molnupiravir, azvudine, and nirmatrelvir/ritonavir were administered to 67 (20.7%), 11 (3.4%), and 148 (45.7%) patients, respectively. Twenty-nine (9.0%) patients were treated with more than one antiviral agent. Forty-eight (14.8%) patients were treated with tocilizumab and 53 (16.4%) patients received baricitinib therapy. The acute kidney injury (AKI) occurred in 81 (25.0%) patients and 39 (12.0%) patients were admitted to intensive care units. Fungal infections were observed in 55 (17.0%) patients. Fifty (15.4%) patients lost their graft. The 28-d mortality rate of patients was 9.0% and 42 (13.0%) patients died by the end of follow-up. Multivariate Cox regression analysis identified that cerebrovascular disease, AKI incidence, interleukin (IL)-6 level of >6.8 pg/mL, daily dose of corticosteroids of >50 mg, and fungal infection were all associated with an increased risk of death for hospitalized patients. CONCLUSIONS: Our findings demonstrate that hospitalized KTRs with COVID-19 are at high risk of mortality. The administration of immunomodulators or the late application of antiviral drugs does not improve patient survival, while higher doses of corticosteroids may increase the death risk.
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Affiliation(s)
- Duo Lv
- Department of Clinical Pharmacy, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
- Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, Hangzhou 310003, China
| | - Xishao Xie
- Kidney Disease Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
- Key Laboratory of Kidney Disease Prevention and Control Technology, Zhejiang Province, Hangzhou 310003, China
- Institute of Nephrology, Zhejiang University, Hangzhou 310003, China
- Zhejiang Clinical Research Center of Kidney and Urinary System Disease, Hangzhou 310003, China
- The Third Grade Laboratory under the National State, Administration of Traditional Chinese Medicine, Hangzhou 310003, China
| | - Qinyun Yang
- Information Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Zhimin Chen
- Kidney Disease Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
- Key Laboratory of Kidney Disease Prevention and Control Technology, Zhejiang Province, Hangzhou 310003, China
- Institute of Nephrology, Zhejiang University, Hangzhou 310003, China
- Zhejiang Clinical Research Center of Kidney and Urinary System Disease, Hangzhou 310003, China
- The Third Grade Laboratory under the National State, Administration of Traditional Chinese Medicine, Hangzhou 310003, China
| | - Guangjun Liu
- Kidney Disease Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
- Key Laboratory of Kidney Disease Prevention and Control Technology, Zhejiang Province, Hangzhou 310003, China
- Institute of Nephrology, Zhejiang University, Hangzhou 310003, China
- Zhejiang Clinical Research Center of Kidney and Urinary System Disease, Hangzhou 310003, China
- The Third Grade Laboratory under the National State, Administration of Traditional Chinese Medicine, Hangzhou 310003, China
| | - Wenhan Peng
- Kidney Disease Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
- Key Laboratory of Kidney Disease Prevention and Control Technology, Zhejiang Province, Hangzhou 310003, China
- Institute of Nephrology, Zhejiang University, Hangzhou 310003, China
- Zhejiang Clinical Research Center of Kidney and Urinary System Disease, Hangzhou 310003, China
- The Third Grade Laboratory under the National State, Administration of Traditional Chinese Medicine, Hangzhou 310003, China
| | - Rending Wang
- Kidney Disease Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
- Key Laboratory of Kidney Disease Prevention and Control Technology, Zhejiang Province, Hangzhou 310003, China
- Institute of Nephrology, Zhejiang University, Hangzhou 310003, China
- Zhejiang Clinical Research Center of Kidney and Urinary System Disease, Hangzhou 310003, China
- The Third Grade Laboratory under the National State, Administration of Traditional Chinese Medicine, Hangzhou 310003, China
| | - Hongfeng Huang
- Kidney Disease Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
- Key Laboratory of Kidney Disease Prevention and Control Technology, Zhejiang Province, Hangzhou 310003, China
- Institute of Nephrology, Zhejiang University, Hangzhou 310003, China
- Zhejiang Clinical Research Center of Kidney and Urinary System Disease, Hangzhou 310003, China
- The Third Grade Laboratory under the National State, Administration of Traditional Chinese Medicine, Hangzhou 310003, China
| | - Jianghua Chen
- Kidney Disease Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
- Key Laboratory of Kidney Disease Prevention and Control Technology, Zhejiang Province, Hangzhou 310003, China
- Institute of Nephrology, Zhejiang University, Hangzhou 310003, China
- Zhejiang Clinical Research Center of Kidney and Urinary System Disease, Hangzhou 310003, China
- The Third Grade Laboratory under the National State, Administration of Traditional Chinese Medicine, Hangzhou 310003, China
| | - Jianyong Wu
- Kidney Disease Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
- Key Laboratory of Kidney Disease Prevention and Control Technology, Zhejiang Province, Hangzhou 310003, China.
- Institute of Nephrology, Zhejiang University, Hangzhou 310003, China.
- Zhejiang Clinical Research Center of Kidney and Urinary System Disease, Hangzhou 310003, China.
- The Third Grade Laboratory under the National State, Administration of Traditional Chinese Medicine, Hangzhou 310003, China.
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Al Balushi H, Kurdi A, Almutairi N, Baker KI, Amen KM, Karwi H, Seaton A, Godman B. Impact of the COVID-19 pandemic on the utilisation and quality of antibiotic use in the Scottish primary care setting: a population-based segmented interrupted time-series analysis. Expert Rev Anti Infect Ther 2024:1-11. [PMID: 38836493 DOI: 10.1080/14787210.2024.2363485] [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: 09/16/2023] [Accepted: 05/30/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND Inappropriate use of antibiotics is expected to increase during the COVID-19 pandemic, but there are limited data on COVID-19's long-term impact. We assessed the impact of COVID-19 on the quantity and quality of antibiotic use in Scotland. RESEARCH DESIGN AND METHODS A segmented interrupted time series was applied to monthly dispensed antibiotics using prescription cost analysis data from March/2019 to March/2023. Antibiotic use was quantified using the number of items dispensed/1000 inhabitants (TIDs) and defined daily dose/1000 inhabitants/day (DIDs). The quality of antibiotic use was assessed using key quality indicators including the WHO AWaRe classification, proportion of broad-spectrum and "4C"-antibiotics. RESULTS Overall, for all antibiotics, there was a non-significant increase in TIDs and DIDs before the first lockdown (March/2020) (β1), but a decline in the level immediately after the first (β2) and second lockdowns (β4) (November/2020), albeit non-significant. However, a significant increase in the time trend after the second lockdown (β5) for all antibiotic classes was observed. COVID-19 had no negative impact on AWaRe utilisation, with the proportion of all antibiotics from the Access group increasing from 76% in March/2019 to 90% in March/2023. The proportion of "4C" antibiotic reduced significantly after the second lockdown. CONCLUSIONS Neither the utilisation nor the quality of total antibiotic use appeared to have been significantly affected by COVID-19.
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Affiliation(s)
- Hayam Al Balushi
- Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University, Glasgow, UK
- Directorate General of Pharmaceutical Affairs and Drug Control, Ministry of Health, Oman
| | - Amanj Kurdi
- Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University, Glasgow, UK
- Department of Clinical Pharmacy, College of Pharmacy, Hawler Medical University, Kurdistan Regional Governorate, Erbil, Iraq
- College of Pharmacy, Al-Kitab University, Kirkuk, Iraq
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Najla Almutairi
- Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University, Glasgow, UK
| | | | - Karwan M Amen
- Department of Nursing, College of Nursing, Hawler Medical University, Erbil, Iraq
| | - Hardee Karwi
- Azadi Teaching Hospital, Kirkuk Health Directorate, Ministry of Health, Kirkuk, Iraq
| | - Andrew Seaton
- Department of Internal Medicine, Queen Elizabeth University Hospital, Glasgow, UK
- School of Medicine, University of Glasgow, Glasgow, UK
| | - Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University, Glasgow, UK
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12
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Greenhalgh T, MacIntyre CR, Baker MG, Bhattacharjee S, Chughtai AA, Fisman D, Kunasekaran M, Kvalsvig A, Lupton D, Oliver M, Tawfiq E, Ungrin M, Vipond J. Masks and respirators for prevention of respiratory infections: a state of the science review. Clin Microbiol Rev 2024; 37:e0012423. [PMID: 38775460 DOI: 10.1128/cmr.00124-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024] Open
Abstract
SUMMARYThis narrative review and meta-analysis summarizes a broad evidence base on the benefits-and also the practicalities, disbenefits, harms and personal, sociocultural and environmental impacts-of masks and masking. Our synthesis of evidence from over 100 published reviews and selected primary studies, including re-analyzing contested meta-analyses of key clinical trials, produced seven key findings. First, there is strong and consistent evidence for airborne transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other respiratory pathogens. Second, masks are, if correctly and consistently worn, effective in reducing transmission of respiratory diseases and show a dose-response effect. Third, respirators are significantly more effective than medical or cloth masks. Fourth, mask mandates are, overall, effective in reducing community transmission of respiratory pathogens. Fifth, masks are important sociocultural symbols; non-adherence to masking is sometimes linked to political and ideological beliefs and to widely circulated mis- or disinformation. Sixth, while there is much evidence that masks are not generally harmful to the general population, masking may be relatively contraindicated in individuals with certain medical conditions, who may require exemption. Furthermore, certain groups (notably D/deaf people) are disadvantaged when others are masked. Finally, there are risks to the environment from single-use masks and respirators. We propose an agenda for future research, including improved characterization of the situations in which masking should be recommended or mandated; attention to comfort and acceptability; generalized and disability-focused communication support in settings where masks are worn; and development and testing of novel materials and designs for improved filtration, breathability, and environmental impact.
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Affiliation(s)
- Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - C Raina MacIntyre
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Michael G Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Shovon Bhattacharjee
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia
- School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, Australia
| | - Abrar A Chughtai
- School of Population Health, University of New South Wales, Sydney, Australia
| | - David Fisman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Mohana Kunasekaran
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Amanda Kvalsvig
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Deborah Lupton
- Centre for Social Research in Health and Social Policy Research Centre, Faculty of Arts, Design and Architecture, University of New South Wales, Sydney, Australia
| | - Matt Oliver
- Professional Standards Advocate, Edmonton, Canada
| | - Essa Tawfiq
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Mark Ungrin
- Faculty of Veterinary Medicine; Department of Biomedical Engineering, Schulich School of Engineering; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Joe Vipond
- Department of Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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13
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Shen C, Song Z, He P, Liu L, Xiong Z. Online rumors during the COVID-19 pandemic: co-evolution of themes and emotions. Front Public Health 2024; 12:1375731. [PMID: 38919926 PMCID: PMC11196962 DOI: 10.3389/fpubh.2024.1375731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 05/20/2024] [Indexed: 06/27/2024] Open
Abstract
Introduction During public health emergencies, online rumors spread widely on social media, causing public information anxiety and emotional fluctuations. Analyzing the co-evolution patterns of online rumor themes and emotions is essential for implementing proactive and precise governance of online rumors during such events. Methods Rumor texts from mainstream fact-checking platforms during the COVID-19 pandemic were collected and analyzed in phases based on the crisis lifecycle theory. The LDA topic model was applied to analyze the distribution of rumor themes at different stages. The Baidu AI Sentiment Analysis API was used to study the emotional tendencies of rumors at different stages. Line graphs were utilized to analyze the co-evolution characteristics of rumor themes and emotions. Results During the COVID-19 pandemic, the themes of online rumors can be categorized into five types: epidemic prevention and control, panic-inducing, production and livelihood, virus dissemination, and social figures. These themes exhibited repetition and fluctuation at different stages of the pandemic. The emotions embedded in pandemic-related online rumors evolved with the progression of the pandemic. Panic-inducing rumors co-evolved with negative emotions, while epidemic prevention and control rumors co-evolved with positive emotions. Conclusion The study results help to understand the public's focus and emotional tendencies at different stages of the COVID-19 pandemic, thereby enabling targeted public opinion guidance and crisis management.
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Affiliation(s)
| | | | - Pengyu He
- School of Management, Nanjing University of Posts and Telecommunications, Nanjing, China
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Bendavid E, Patel CJ. Epidemic outcomes following government responses to COVID-19: Insights from nearly 100,000 models. SCIENCE ADVANCES 2024; 10:eadn0671. [PMID: 38838157 DOI: 10.1126/sciadv.adn0671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 05/03/2024] [Indexed: 06/07/2024]
Abstract
Government responses to COVID-19 are among the most globally impactful events of the 21st century. The extent to which responses-such as school closures-were associated with changes in COVID-19 outcomes remains unsettled. Multiverse analyses offer a systematic approach to testing a large range of models. We used daily data on 16 government responses in 181 countries in 2020-2021, and 4 outcomes-cases, infections, COVID-19 deaths, and all-cause excess deaths-to construct 99,736 analytic models. Among those, 42% suggest outcomes improved following more stringent responses ("helpful"). No subanalysis (e.g. limited to cases as outcome) demonstrated a preponderance of helpful or unhelpful associations. Among the 14 associations with P values < 1 × 10-30, 5 were helpful and 9 unhelpful. In summary, we find no patterns in the overall set of models that suggests a clear relationship between COVID-19 government responses and outcomes. Strong claims about government responses' impacts on COVID-19 may lack empirical support.
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Affiliation(s)
- Eran Bendavid
- Department of Medicine, Stanford University, Stanford, CA, USA
- Department of Health Policy, Stanford University, Stanford, CA, USA
| | - Chirag J Patel
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
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15
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McClymont H, Hu W. The effect of public health interventions on COVID-19 incidence in Queensland, Australia: a spatial cluster analysis. Infect Dis (Lond) 2024; 56:460-475. [PMID: 38446488 DOI: 10.1080/23744235.2024.2324355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 02/23/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Using SaTScan™ Geographical Information Systems (GIS), spatial cluster analysis was used to examine spatial trends and identify high-risk clusters of Coronavirus 2019 (COVID-19) incidence in response to changing levels of public health intervention phases including international and state border closures, statewide vaccination coverage, and masking requirements. METHODS Changes in COVID-19 incidence were mapped at the statistical area 2 (SA2) level using a GIS and spatial cluster analysis was performed using SaTScan™ to identify most-likely clusters (MLCs) during intervention phases. RESULTS Over the study period, significant high-risk clusters were identified in Brisbane city (relative risk = 30.83), the southeast region (RR = 1.71) and moving to Far North Queensland (FNQ) (RR = 2.64). For masking levels, cluster locations were similar, with MLC in phase 1 in the southeast region (RR = 2.56) spreading to FNQ in phase 2 (RR = 2.22) and phase 3 (RR = 2.64). All p values <.0001. CONCLUSIONS Movement restrictions in the form of state and international border closures were highly effective in delaying the introduction of COVID-19 into Queensland, with very low levels of transmission prior to border reopening while mandatory masking may have played a role in decreasing transmission through behavioural changes. Early clusters were in highly populated regions, as restrictions eased clusters were identified in regions more likely to be rural or remote, with higher numbers of Indigenous people, lower vaccination coverage or lower socioeconomic status.
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Affiliation(s)
- Hannah McClymont
- School of Public Health and Social Work, Ecosystem Change, Population Health and Early Warning (ECAPH) Research Group, Queensland University of Technology (QUT), Brisbane, Australia
| | - Wenbiao Hu
- School of Public Health and Social Work, Ecosystem Change, Population Health and Early Warning (ECAPH) Research Group, Queensland University of Technology (QUT), Brisbane, Australia
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16
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Ryan M, Brindal E, Roberts M, Hickson RI. A behaviour and disease transmission model: incorporating the Health Belief Model for human behaviour into a simple transmission model. J R Soc Interface 2024; 21:20240038. [PMID: 38835247 DOI: 10.1098/rsif.2024.0038] [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: 01/18/2024] [Accepted: 04/10/2024] [Indexed: 06/06/2024] Open
Abstract
The health and economic impacts of infectious diseases such as COVID-19 affect all levels of a community from the individual to the governing bodies. However, the spread of an infectious disease is intricately linked to the behaviour of the people within a community since crowd behaviour affects individual human behaviour, while human behaviour affects infection spread, and infection spread affects human behaviour. Capturing these feedback loops of behaviour and infection is a well-known challenge in infectious disease modelling. Here, we investigate the interface of behavioural science theory and infectious disease modelling to explore behaviour and disease (BaD) transmission models. Specifically, we incorporate a visible protective behaviour into the susceptible-infectious-recovered-susceptible (SIRS) transmission model using the socio-psychological Health Belief Model to motivate behavioural uptake and abandonment. We characterize the mathematical thresholds for BaD emergence in the BaD SIRS model and the feasible steady states. We also explore, under different infectious disease scenarios, the effects of a fully protective behaviour on long-term disease prevalence in a community, and describe how BaD modelling can investigate non-pharmaceutical interventions that target-specific components of the Health Belief Model. This transdisciplinary BaD modelling approach may reduce the health and economic impacts of future epidemics.
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Affiliation(s)
- Matthew Ryan
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) , Adelaide, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University , Townsville, Australia
| | - Emily Brindal
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) , Adelaide, Australia
| | - Mick Roberts
- New Zealand Institute for Advanced Study, Massey University , Auckland, New Zealand
| | - Roslyn I Hickson
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) , Adelaide, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University , Townsville, Australia
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17
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Meng S, Zeng Z, Zuo H, Wang J. Sex Difference in Characteristics and Predictors of In-Hospital Mortality among Patients with COVID-19. Respiration 2024:1-8. [PMID: 38768572 DOI: 10.1159/000539281] [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: 11/17/2023] [Accepted: 05/08/2024] [Indexed: 05/22/2024] Open
Abstract
INTRODUCTION With a surge in the prevalence of coronavirus disease-2019 (COVID-19) in Beijing starting in October 2022, hospitalisation rates increased markedly. This study aimed to evaluate factors associated with in-hospital mortality in patients with COVID-19. METHODS Using data from hospitalised patients, sex-based differences in clinical characteristics, in-hospital management, and in-hospital mortality among patients diagnosed with COVID-19 were evaluated. Predictive factors associated with mortality in 1,091 patients admitted to the Beijing Anzhen Hospital (Beijing, China) for COVID-19 between October 2022 and January 2023 were also evaluated. RESULTS Data from 1,091 patients hospitalised with COVID-19 were included in the analysis. In-hospital mortality rates for male and female patients were 14.9% and 10.4%, respectively. Multifactorial logistic analysis indicated that lymphocyte percentage (LYM%) (odds ratio [OR] 0.863, 95% confidence interval [CI] 0.805-0.925; p < 0.001), uric acid (OR 1.004, 95% CI: 1.002-1.006; p = 0.001), and high-sensitivity C-reactive protein (OR 1.094, 95% CI: 1.012-1.183; p = 0.024) levels were independently associated with COVID-19-related in-hospital mortality. Among female patients, multifactorial analysis revealed that LYM% (OR 0.856, 95% CI: 0.796-0.920; p < 0.001), older age (OR 1.061, 95% CI: 1.020-1.103; p = 0.003), obesity (OR 2.590, 95% CI: 1.131-5.931; p = 0.024), and a high high-sensitivity troponin I level (OR 2.602, 95% CI: 1.157-5.853; p = 0.021) were risk factors for in-hospital mortality. Receiver operating characteristic (ROC) curve analysis, including area under the ROC curve, showed that the efficacy of LYM% in predicting in-hospital death was 0.800 (sensitivity, 63.2%; specificity, 83.2%) in male patients and 0.815 (sensitivity, 87.5%; specificity, 64.4%) in female patients. CONCLUSION LYM% is a consistent predictor of in-hospital mortality for both sexes. Older age and markers of systemic inflammation, myocardial injury, and metabolic dysregulation are also associated with a high mortality risk. These findings may help identify patients who require closer monitoring and tailored interventions to improve outcomes.
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Affiliation(s)
- Shirui Meng
- Queen Mary School, Jiangxi Medical College, Nanchang University, Nanchang, China,
| | - Zechun Zeng
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Huijuan Zuo
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jinwen Wang
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
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18
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Veeken LD, Opdam MAA, Verhoef LM, Popa C, van Crevel R, den Broeder AA. Infection incidence, timing and dose dependency in rheumatoid arthritis patients treated with rituximab: a retrospective cohort study. Rheumatology (Oxford) 2024; 63:1246-1250. [PMID: 37410085 DOI: 10.1093/rheumatology/kead328] [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: 02/15/2023] [Revised: 06/07/2023] [Accepted: 06/27/2023] [Indexed: 07/07/2023] Open
Abstract
OBJECTIVES Rituximab (RTX) is a safe and effective treatment for RA. However, there are some concerns about infection risk and preliminary data suggest dose and time dependency. This study aims to determine the infection incidence in a large real-life population of RA patients using RTX, with special focus on (ultra-)low dosing and time since last infusion. METHODS RA patients treated with 1000, 500 or 200 mg RTX per cycle between 2012 and 2021 at the Sint Maartenskliniek were included in a retrospective cohort study. Patient-, disease-, treatment- and infection characteristics were retrieved from electronic health records. Infection incidence rates, dose and time relations with RTX infusion were analysed using mixed-effects Poisson regression. RESULTS Among 490 patients, we identified 819 infections in 1254 patient years. Most infections were mild and respiratory tract infections were most common. Infection incidence rates were 41, 54 and 71 per 100 patient years for doses of 200, 500 and 1000 mg. Incidence rate ratio (IRR) was significantly lower for 200 mg compared with 1000 mg (adjusted IRR 0.35, 95% CI 0.17, 0.72, P = 0.004). In patients receiving 1000 or 500 mg RTX, infections seemed to occur more frequently within the first two months after infusion compared with later on in the treatment cycle, suggesting an association with peak concentration. CONCLUSION Ultra-low dosing (200 mg) of RTX is associated with a lower risk of infections in RA. Future interventions focusing on ultra-low dosing and slow release of RTX (e.g. by subcutaneous administration) may lower infection risk.
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Affiliation(s)
- Lara D Veeken
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - Merel A A Opdam
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands
- Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Lise M Verhoef
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - Calin Popa
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands
- Department of Rheumatology, Radboudumc, Nijmegen, The Netherlands
| | - Reinout van Crevel
- Department of Infectious Diseases, Radboudumc, Nijmegen, The Netherlands
| | - Alfons A den Broeder
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands
- Department of Rheumatology, Radboudumc, Nijmegen, The Netherlands
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Littlecott H, Krishnaratne S, Burns J, Rehfuess E, Sell K, Klinger C, Strahwald B, Movsisyan A, Metzendorf MI, Schoenweger P, Voss S, Coenen M, Müller-Eberstein R, Pfadenhauer LM. Measures implemented in the school setting to contain the COVID-19 pandemic. Cochrane Database Syst Rev 2024; 5:CD015029. [PMID: 38695826 PMCID: PMC11064884 DOI: 10.1002/14651858.cd015029.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Abstract
BACKGROUND More than 767 million coronavirus 2019 (COVID-19) cases and 6.9 million deaths with COVID-19 have been recorded as of August 2023. Several public health and social measures were implemented in schools to contain the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and prevent onward transmission. We built upon methods from a previous Cochrane review to capture current empirical evidence relating to the effectiveness of school measures to limit SARS-CoV-2 transmission. OBJECTIVES To provide an updated assessment of the evidence on the effectiveness of measures implemented in the school setting to keep schools open safely during the COVID-19 pandemic. SEARCH METHODS We searched the Cochrane COVID-19 Study Register, Educational Resources Information Center, World Health Organization (WHO) COVID-19 Global literature on coronavirus disease database, and the US Department of Veterans Affairs Evidence Synthesis Program COVID-19 Evidence Reviews on 18 February 2022. SELECTION CRITERIA Eligible studies focused on measures implemented in the school setting to contain the COVID-19 pandemic, among students (aged 4 to 18 years) or individuals relating to the school, or both. We categorized studies that reported quantitative measures of intervention effectiveness, and studies that assessed the performance of surveillance measures as either 'main' or 'supporting' studies based on design and approach to handling key confounders. We were interested in transmission-related outcomes and intended or unintended consequences. DATA COLLECTION AND ANALYSIS Two review authors screened titles, abstracts and full texts. We extracted minimal data for supporting studies. For main studies, one review author extracted comprehensive data and assessed risk of bias, which a second author checked. We narratively synthesized findings for each intervention-comparator-outcome category (body of evidence). Two review authors assessed certainty of evidence. MAIN RESULTS The 15 main studies consisted of measures to reduce contacts (4 studies), make contacts safer (7 studies), surveillance and response measures (6 studies; 1 assessed transmission outcomes, 5 assessed performance of surveillance measures), and multicomponent measures (1 study). These main studies assessed outcomes in the school population (12), general population (2), and adults living with a school-attending child (1). Settings included K-12 (kindergarten to grade 12; 9 studies), secondary (3 studies), and K-8 (kindergarten to grade 8; 1 study) schools. Two studies did not clearly report settings. Studies measured transmission-related outcomes (10), performance of surveillance measures (5), and intended and unintended consequences (4). The 15 main studies were based in the WHO Regions of the Americas (12), and the WHO European Region (3). Comparators were more versus less intense measures, single versus multicomponent measures, and measures versus no measures. We organized results into relevant bodies of evidence, or groups of studies relating to the same 'intervention-comparator-outcome' categories. Across all bodies of evidence, certainty of evidence ratings limit our confidence in findings. Where we describe an effect as 'beneficial', the direction of the point estimate of the effect favours the intervention; a 'harmful' effect does not favour the intervention and 'null' shows no effect either way. Measures to reduce contact (4 studies) We grouped studies into 21 bodies of evidence: moderate- (10 bodies), low- (3 bodies), or very low-certainty evidence (8 bodies). The evidence was very low to moderate certainty for beneficial effects of remote versus in-person or hybrid teaching on transmission in the general population. For students and staff, mostly harmful effects were observed when more students participated in remote teaching. Moderate-certainty evidence showed that in the general population there was probably no effect on deaths and a beneficial effect on hospitalizations for remote versus in-person teaching, but no effect for remote versus hybrid teaching. The effects of hybrid teaching, a combination of in-person and remote teaching, were mixed. Very low-certainty evidence showed that there may have been a harmful effect on risk of infection among adults living with a school student for closing playgrounds and cafeterias, a null effect for keeping the same teacher, and a beneficial effect for cancelling extracurricular activities, keeping the same students together and restricting entry for parents and caregivers. Measures to make contact safer (7 studies) We grouped studies into eight bodies of evidence: moderate- (5 bodies), and low-certainty evidence (3 bodies). Low-certainty evidence showed that there may have been a beneficial effect of mask mandates on transmission-related outcomes. Moderate-certainty evidence showed full mandates were probably more beneficial than partial or no mandates. Evidence of a beneficial effect of physical distancing on risk of infection among staff and students was mixed. Moderate-certainty evidence showed that ventilation measures probably reduce cases among staff and students. One study (very low-certainty evidence) found that there may be a beneficial effect of not sharing supplies and increasing desk space on risk of infection for adults living with a school student, but showed there may be a harmful effect of desk shields. Surveillance and response measures (6 studies) We grouped studies into seven bodies of evidence: moderate- (3 bodies), low- (1 body), and very low-certainty evidence (3 bodies). Daily testing strategies to replace or reduce quarantine probably helped to reduce missed school days and decrease the proportion of asymptomatic school contacts testing positive (moderate-certainty evidence). For studies that assessed the performance of surveillance measures, the proportion of cases detected by rapid antigen detection testing ranged from 28.6% to 95.8%, positive predictive value ranged from 24.0% to 100.0% (very low-certainty evidence). There was probably no onward transmission from contacts of a positive case (moderate-certainty evidence) and replacing or shortening quarantine with testing may have reduced missed school days (low-certainty evidence). Multicomponent measures (1 study) Combining multiple measures may have led to a reduction in risk of infection among adults living with a student (very low-certainty evidence). AUTHORS' CONCLUSIONS A range of measures can have a beneficial effect on transmission-related outcomes, healthcare utilization and school attendance. We rated the current findings at a higher level of certainty than the original review. Further high-quality research into school measures to control SARS-CoV-2 in a wider variety of contexts is needed to develop a more evidence-based understanding of how to keep schools open safely during COVID-19 or a similar public health emergency.
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Affiliation(s)
- Hannah Littlecott
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Shari Krishnaratne
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Jacob Burns
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Eva Rehfuess
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Kerstin Sell
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Carmen Klinger
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Brigitte Strahwald
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Ani Movsisyan
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Maria-Inti Metzendorf
- Institute of General Practice, Medical Faculty of the Heinrich-Heine University, Düsseldorf, Germany
| | - Petra Schoenweger
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Stephan Voss
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Michaela Coenen
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Roxana Müller-Eberstein
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Lisa M Pfadenhauer
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
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Ambrosio L, Faulkner J, Morris JH, Stuart B, Lambrick D, Compton E, Portillo MC. Physical activity and mental health in individuals with multimorbidity during COVID-19: an explanatory sequential mixed-method study. BMJ Open 2024; 14:e079852. [PMID: 38670621 PMCID: PMC11057318 DOI: 10.1136/bmjopen-2023-079852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 04/14/2024] [Indexed: 04/28/2024] Open
Abstract
OBJECTIVE To understand the physical activity and mental health of individuals living with long-term conditions during the COVID-19 pandemic. DESIGN A sequential explanatory mixed-methods study with two phases: phase 1: quantitative survey and phase 2: qualitative follow-up interviews. SETTING For the quantitative phase, an online survey was launched in March 2021, using Microsoft Forms. For the qualitative phase, in-depth semistructured interviews were conducted via online. PARTICIPANTS 368 adults over 18 years old living in the UK with at least one long-term condition completed the survey. Interviews were conducted in a subsample of participants from the previous quantitative phase, with 26 people. Data were analysed using thematic analysis. RESULTS Responses from the survey showed that people with one long-term condition were significantly more physically active and spent less time sitting, than those with two or more conditions, presenting with significantly higher well-being (p<0.0001), and lower levels of anxiety (p<0.01), and depression (p<0.0001). Interviews found that people developed a range of strategies to cope with the impact of changeability and the consequences of their long-term condition on their physical activity. CONCLUSIONS The number of long-term conditions influenced physical activity and how people coped with their condition during COVID-19. Findings will inform policy developments in preparation for future pandemics to support and remain people to remain physically active and mental health.
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Affiliation(s)
- Leire Ambrosio
- School of Health Sciences, University of Southampton, Southampton, UK
- National Institute for Health and Care Research, Applied Research Collaboration Wessex, Southampton, UK
| | - James Faulkner
- Department of Sport, Exercise and Health, University of Winchester, Winchester, UK
| | | | - Beth Stuart
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Danielle Lambrick
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Eric Compton
- Person with long term conditions, Public and patient Involvement, Southampton, UK
| | - Mari Carmen Portillo
- School of Health Sciences, University of Southampton, Southampton, UK
- National Institute for Health and Care Research, Applied Research Collaboration Wessex, Southampton, UK
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21
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Totzkay D, Fraustino JD, Smith BT, Jarrett T, Dino GA, Costello LM, Kristjansson AL. Predicting COVID-19 Vaccination Intentions to Inform Evidence-Based Messaging for Building Vaccine Confidence Among Rural Americans. Am J Health Promot 2024:8901171241249281. [PMID: 38652835 DOI: 10.1177/08901171241249281] [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: 04/25/2024]
Abstract
PURPOSE Examine possible message topics to promote rural vaccination using psychosocial antecedents of vaccination. DESIGN Cross-sectional survey administered by Research America, Inc. SETTING West Virginia (WV). SAMPLE 756 WV adults via convenience sample (n = 370; ∼2% response rate from online panel of ∼20 000 WV residents), and random digit dial of landlines (n = 174; ∼1% response rate from 18 432 numbers) and cellphones (n = 212; ∼1% response rate from 20 486 numbers). MEASURES Outcome measures included self-reported vaccination intention and behavior. Predictor measures, rooted in theories of social and behavioral science that have been found to be predictive of vaccination outcomes (i.e., Reasoned Action Approach, Extended Parallel Process Model), included perceived severity and susceptibility, negative affect, instrumental and affective attitudes, social norms, self-efficacy, response efficacy, and perceived control. ANALYSIS Multivariate linear regression for intention and logistic regression for behavior. RESULTS Intention was positively predicted by affective attitude, β = .30, P < .05, instrumental attitude, β = .19, P < .05, response efficacy, β = .19, P < .05, negative affect, β = .16, P < .05, self-efficacy, β = .13, P < .05, and subjective norm, β = .13, P < .05, F(10, 267) = 30.12, Adj. R2 = .53. Vaccination status was predicted by instrumental attitude, exp(B) = 2.09, and subjective norm, exp(B) = 2.00, Pseudo R2 = .29, log likelihood = 125.11, χ2(10) = 38.34, P < .05. Promising message targets were instrumental attitude, M = 3.21, SD = 1.46, and subjective norms, M = 3.76, SD = 1.71. CONCLUSION COVID-19 vaccine confidence messages should address (1) positive feelings and safety perceptions, (2) vaccination's effectiveness in preventing serious COVID-19, and (3) subjective vaccination norms.
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Affiliation(s)
- Daniel Totzkay
- West Virginia University, Morgantown, WV, USA
- WVU Public Interest Communication Research Laboratory, Morgantown, WV, USA
| | - Julia Daisy Fraustino
- West Virginia University, Morgantown, WV, USA
- WVU Public Interest Communication Research Laboratory, Morgantown, WV, USA
| | - Brittany T Smith
- West Virginia University, Morgantown, WV, USA
- West Virginia Prevention Research Center, Morgantown, WV, USA
| | - Traci Jarrett
- West Virginia University, Morgantown, WV, USA
- West Virginia Prevention Research Center, Morgantown, WV, USA
| | - Geri A Dino
- West Virginia University, Morgantown, WV, USA
- West Virginia Prevention Research Center, Morgantown, WV, USA
| | - Lisa M Costello
- West Virginia University, Morgantown, WV, USA
- WVU Public Interest Communication Research Laboratory, Morgantown, WV, USA
| | - Alfgeir L Kristjansson
- West Virginia University, Morgantown, WV, USA
- West Virginia Prevention Research Center, Morgantown, WV, USA
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Meisgeier A, Pienkohs S, Moosdorf L, Neff A. Impact of the COVID-19 pandemic on maxillofacial trauma surgery in Germany - implications from the national DRG database. Oral Maxillofac Surg 2024:10.1007/s10006-024-01248-9. [PMID: 38600413 DOI: 10.1007/s10006-024-01248-9] [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: 09/28/2023] [Accepted: 03/29/2024] [Indexed: 04/12/2024]
Abstract
PURPOSE The COVID-19 pandemic has affected the personal and social lives of millions of people and also impacted the etiological factors of midfacial trauma such as falls, interpersonal violence or traffic accidents. The aim of this study was to analyze the influence of the COVID-19 pandemic on maxillofacial trauma surgery in the German healthcare system. METHODS Nationwide data regarding the national diagnosis-related-group (DRG) inpatient billing system used in all German hospitals was received from the German Federal Statistical Office. Various trauma-associated procedures of the Operation and Procedure Classification System (OPS), a German modification of the International Classification of Medical Procedures (ICPM), were statistically associated with different epidemiological factors between 2012 and 2021. RESULTS A statistically significant decrease (p < 0.05) in surgeries regarding maxillofacial fractures was registered during the years 2020 and 2021. Young male patients had the largest decline in maxillofacial trauma surgeries during this period (p < 0.05). In contrast. elderly patients 80 years and older showed a dramatic increase in the frequency of fractures in both the midface and the mandible (p < 0.05). CONCLUSIONS During the COVID 19 pandemic there has been a shift in the number, composition and etiology of maxillofacial fracture surgeries. Measures of social distancing and personal risk avoidance had a societal positive effect on the frequency of facial injuries. This stands in contrast to the drastic increase in fractures of elderly people who should be protected primarily by the measures taken. These results can help to understand these influences better in future pandemics. TRIAL REGISTRATION German Clinical Trials Register No: DRKS00032778.
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Affiliation(s)
- Axel Meisgeier
- Department of Oral and Craniomaxillofacial Surgery, Faculty of Medicine, UKGM GmbH, University Hospital Marburg, Philipps University, 35043, Marburg, Germany.
| | - Simon Pienkohs
- Department of Oral and Craniomaxillofacial Surgery, Faculty of Medicine, UKGM GmbH, University Hospital Marburg, Philipps University, 35043, Marburg, Germany
| | - Laura Moosdorf
- Center for Orthopaedics and Trauma Surgery, Faculty of Medicine, UKGM GmbH, University Hospital Marburg, Philipps University, Marburg, Germany
| | - Andreas Neff
- Department of Oral and Craniomaxillofacial Surgery, Faculty of Medicine, UKGM GmbH, University Hospital Marburg, Philipps University, 35043, Marburg, Germany
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Constantin AM, Noertjojo K, Sommer I, Pizarro AB, Persad E, Durao S, Nussbaumer-Streit B, McElvenny DM, Rhodes S, Martin C, Sampson O, Jørgensen KJ, Bruschettini M. Workplace interventions to reduce the risk of SARS-CoV-2 infection outside of healthcare settings. Cochrane Database Syst Rev 2024; 4:CD015112. [PMID: 38597249 PMCID: PMC11005086 DOI: 10.1002/14651858.cd015112.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
BACKGROUND Although many people infected with SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) experience no or mild symptoms, some individuals can develop severe illness and may die, particularly older people and those with underlying medical problems. Providing evidence-based interventions to prevent SARS-CoV-2 infection has become more urgent with the potential psychological toll imposed by the coronavirus disease 2019 (COVID-19) pandemic. Controlling exposures to occupational hazards is the fundamental method of protecting workers. When it comes to the transmission of viruses, workplaces should first consider control measures that can potentially have the most significant impact. According to the hierarchy of controls, one should first consider elimination (and substitution), then engineering controls, administrative controls, and lastly, personal protective equipment. This is the first update of a Cochrane review published 6 May 2022, with one new study added. OBJECTIVES To assess the benefits and harms of interventions in non-healthcare-related workplaces aimed at reducing the risk of SARS-CoV-2 infection compared to other interventions or no intervention. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Web of Science Core Collections, Cochrane COVID-19 Study Register, World Health Organization (WHO) COVID-19 Global literature on coronavirus disease, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform, and medRxiv to 13 April 2023. SELECTION CRITERIA We included randomised controlled trials (RCTs) and non-randomised studies of interventions. We included adult workers, both those who come into close contact with clients or customers (e.g. public-facing employees, such as cashiers or taxi drivers), and those who do not, but who could be infected by coworkers. We excluded studies involving healthcare workers. We included any intervention to prevent or reduce workers' exposure to SARS-CoV-2 in the workplace, defining categories of intervention according to the hierarchy of hazard controls (i.e. elimination; engineering controls; administrative controls; personal protective equipment). DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our primary outcomes were incidence rate of SARS-CoV-2 infection (or other respiratory viruses), SARS-CoV-2-related mortality, adverse events, and absenteeism from work. Our secondary outcomes were all-cause mortality, quality of life, hospitalisation, and uptake, acceptability, or adherence to strategies. We used the Cochrane RoB 2 tool to assess risk of bias, and GRADE methods to evaluate the certainty of evidence for each outcome. MAIN RESULTS We identified 2 studies including a total of 16,014 participants. Elimination-of-exposure interventions We included one study examining an intervention that focused on elimination of hazards, which was an open-label, cluster-randomised, non-inferiority trial, conducted in England in 2021. The study compared standard 10-day self-isolation after contact with an infected person to a new strategy of daily rapid antigen testing and staying at work if the test is negative (test-based attendance). The trialists hypothesised that this would lead to a similar rate of infections, but lower COVID-related absence. Staff (N = 11,798) working at 76 schools were assigned to standard isolation, and staff (N = 12,229) working at 86 schools were assigned to the test-based attendance strategy. The results between test-based attendance and standard 10-day self-isolation were inconclusive for the rate of symptomatic polymerase chain reaction (PCR)-positive SARS-CoV-2 infection (rate ratio (RR) 1.28, 95% confidence interval (CI) 0.74 to 2.21; 1 study; very low-certainty evidence). The results between test-based attendance and standard 10-day self-isolation were inconclusive for the rate of any PCR-positive SARS-CoV-2 infection (RR 1.35, 95% CI 0.82 to 2.21; 1 study; very low-certainty evidence). COVID-related absenteeism rates were 3704 absence days in 566,502 days-at-risk (6.5 per 1000 working days) in the control group and 2932 per 539,805 days-at-risk (5.4 per 1000 working days) in the intervention group (RR 0.83, 95% CI 0.55 to 1.25). We downgraded the certainty of the evidence to low due to imprecision. Uptake of the intervention was 71% in the intervention group, but not reported for the control intervention. The trial did not measure our other outcomes of SARS-CoV-2-related mortality, adverse events, all-cause mortality, quality of life, or hospitalisation. We found seven ongoing studies using elimination-of-hazard strategies, six RCTs and one non-randomised trial. Administrative control interventions We found one ongoing RCT that aims to evaluate the efficacy of the Bacillus Calmette-Guérin (BCG) vaccine in preventing COVID-19 infection and reducing disease severity. Combinations of eligible interventions We included one non-randomised study examining a combination of elimination of hazards, administrative controls, and personal protective equipment. The study was conducted in two large retail companies in Italy in 2020. The study compared a safety operating protocol, measurement of body temperature and oxygen saturation upon entry, and a SARS-CoV-2 test strategy with a minimum activity protocol. Both groups received protective equipment. All employees working at the companies during the study period were included: 1987 in the intervention company and 1798 in the control company. The study did not report an outcome of interest for this systematic review. Other intervention categories We did not find any studies in this category. AUTHORS' CONCLUSIONS We are uncertain whether a test-based attendance policy affects rates of PCR-positive SARS-CoV-2 infection (any infection; symptomatic infection) compared to standard 10-day self-isolation amongst school and college staff. A test-based attendance policy may result in little to no difference in absenteeism rates compared to standard 10-day self-isolation. The non-randomised study included in our updated search did not report any outcome of interest for this Cochrane review. As a large part of the population is exposed in the case of a pandemic, an apparently small relative effect that would not be worthwhile from the individual perspective may still affect many people, and thus become an important absolute effect from the enterprise or societal perspective. The included RCT did not report on any of our other primary outcomes (i.e. SARS-CoV-2-related mortality and adverse events). We identified no completed studies on any other interventions specified in this review; however, eight eligible studies are ongoing. More controlled studies are needed on testing and isolation strategies, and working from home, as these have important implications for work organisations.
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Affiliation(s)
- Alexandru Marian Constantin
- Department of Internal Medicine Clinical Hospital Colentina, University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, Danube University Krems, Krems, Austria
| | | | - Isolde Sommer
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, University for Continuing Education Krems, Krems, Austria
| | | | - Emma Persad
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, University for Continuing Education Krems, Krems, Austria
- Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Solange Durao
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Barbara Nussbaumer-Streit
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, University for Continuing Education Krems, Krems, Austria
| | - Damien M McElvenny
- Centre for Occupational and Environmental Health, University of Manchester, Manchester, UK
- Institute of Occupational Medicine, Edinburgh, UK
| | - Sarah Rhodes
- Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | | | | | - Karsten Juhl Jørgensen
- Centre for Evidence-Based Medicine Odense (CEBMO) and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Matteo Bruschettini
- Cochrane Sweden, Department of Research and Education, Lund University, Skåne University Hospital, Lund, Sweden
- Paediatrics, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
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24
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Wang J, Xu X, Wu Q, Zhou C, Yang G. The mediating effect of subject well-being between physical activity and the internet addiction of college students in China during the COVID-19 pandemic: a cross-sectional study. Front Public Health 2024; 12:1368199. [PMID: 38645442 PMCID: PMC11026853 DOI: 10.3389/fpubh.2024.1368199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 03/22/2024] [Indexed: 04/23/2024] Open
Abstract
Background Internet addiction poses a significant threat to the health of college students worldwide, but physical activity, as a highly safe and effective rehabilitative measure, has shown promise for alleviating this issue nowadays. However, during the COVID-19 pandemic, the mediating processes in this association remained unclear. This study aims to explore the impact of physical activity on internet addiction among college students and the mediating role of subjective well-being. Methods A survey was conducted on 216 eligible college students using the physical activity level scale, the internet addiction test, and the subjective well-being scale. For data analysis, independent sample t-tests, correlation analysis, hierarchical regression analysis, and mediating effect tests were in turn carried out in this work. Results The study revealed noteworthy gender disparities in physical activity and internet addiction among college students (β = -0.356, p < 0.01; β = 0.140, p < 0.05). Compared to females, male students manifest elevated levels of physical activity and lower scores in internet addiction. Physical activity and subjective well-being exerted a significantly negative predictive influence on internet addiction (β = -0.162, p < 0.05; β = -0.508, p < 0.001). What's more, subjective well-being assumed a crucial mediating role in the relationship between physical activity and internet addiction, with the mediating effect accounting for 72.81% of the total effect. Conclusion This study deepens the understanding of how physical activity reduces internet addiction risk while emphasizing that enhancing subjective well-being is an effective strategy for college students to cope with Internet addiction.
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Affiliation(s)
- Jinfu Wang
- School of Physical Education, South China University of Technology, Guangzhou, Guangdong, China
| | - Xue Xu
- School of Finance and Economy, Guangdong Engineering Polytechnic, Guangzhou, Guangdong, China
| | - Qinmei Wu
- School of Physical Education, Shandong University, Jinan, Shandong, China
| | - Chao Zhou
- School of Physical Education, South China University of Technology, Guangzhou, Guangdong, China
| | - Guan Yang
- School of Physical Education, South China University of Technology, Guangzhou, Guangdong, China
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Fitri NK, Meliani M, Marpaung K, Cahyadi RAD, Permatasari R, Zainumi CM, Lubis IND. Community Actions and Insights in the Battle against COVID-19 at the Start of the Pandemic: A District Study Observation from Medan, Indonesia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:444. [PMID: 38673355 PMCID: PMC11050628 DOI: 10.3390/ijerph21040444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 03/26/2024] [Accepted: 03/30/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND As of 17 June 2020, the WHO confirmed 8,061,550 COVID-19 cases globally, with Indonesia reporting 40,400 cases and North Sumatra over 932 cases. The rising infection rates have led to increased deaths, highlighting the urgency for public understanding of virus transmission. Despite information dissemination efforts, North Sumatra has not seen a reduction in cases, emphasizing the need for a unified approach to combat the pandemic. OBJECTIVE This study aims to investigate the relationship between public perception and practices regarding COVID-19 prevention in Medan, North Sumatra. METHODS A cross-sectional study will be conducted using a combined questionnaire from two previous studies conducted at the start of the pandemic. RESULTS Among 200 participants, social media was the favored source for prevention information. Participants exhibited above-average knowledge (67.5%) but predominantly below-average attitudes toward prevention (64.5%). However, most residents practiced correct prevention measures (75.5%). CONCLUSIONS Despite possessing adequate knowledge, negative attitudes toward prevention suggest a need for educational interventions to address misconceptions and promote positive behaviors. Such interventions could enhance the community's response to COVID-19 transmission during the pandemic.
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Affiliation(s)
- Nadya Keumala Fitri
- Faculty of Medicine, Universitas Sumatera Utara, Medan 20155, Indonesia; (N.K.F.); (R.A.D.C.)
| | - Meliani Meliani
- Department of Clinical Pathology, Faculty of Medicine, Universitas Sumatera Utara, Medan 20155, Indonesia; (M.M.); (R.P.)
| | - Kartini Marpaung
- Department of Paediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan 20155, Indonesia;
| | | | - Ranti Permatasari
- Department of Clinical Pathology, Faculty of Medicine, Universitas Sumatera Utara, Medan 20155, Indonesia; (M.M.); (R.P.)
| | - Cut Meliza Zainumi
- Department of Anaesthesiology and Intensive Care, Faculty of Medicine, Universitas Sumatera Utara, Medan 20155, Indonesia;
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Ul Mustafa Z, Batool A, Ibrar H, Salman M, Khan YH, Mallhi TH, Meyer JC, Godman B, Moore CE. Bacterial co-infections, secondary infections and antimicrobial use among hospitalized COVID-19 patients in the sixth wave in Pakistan: findings and implications. Expert Rev Anti Infect Ther 2024; 22:229-240. [PMID: 38146949 DOI: 10.1080/14787210.2023.2299387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 11/15/2023] [Indexed: 12/27/2023]
Abstract
INTRODUCTION Previous studies in Pakistan have shown considerable over prescribing of antibiotics in patients hospitalized with COVID-19 despite very low prevalence of bacterial infections. Irrational use of antibiotics will worsen antimicrobial resistance (AMR). METHODS Retrospective analysis of medical records of patients in the COVID-19 wards of three tertiary care hospitals to assess antibiotic use during the sixth COVID-19 wave. RESULTS A total of 284 patients were included, most were male (66.9%), aged 30-50 years (50.7%) with diabetes mellitus the most common comorbidity. The most common symptoms at presentation were cough (47.9%) and arthralgia-myalgia (41.5%). Around 3% were asymptomatic, 34.9% had mild, 30.3% moderate, and 23.6% had severe disease, with 8.1% critical. Chest X-ray abnormalities were seen in 43.3% of patients and 37% had elevated white cell counts, with 35.2% having elevated C-reactive protein levels. Around 91% COVID-19 patients were prescribed antibiotics during their hospital stay, with only a few with proven bacterial co-infections or secondary bacterial infections. Most antibiotics were from the 'Watch' category (90.8%) followed by the 'Reserve' category (4.8%), similar to previous COVID-19 waves. CONCLUSION There continued to be excessive antibiotics use among hospitalized COVID-19 patients in Pakistan. Urgent measures are needed to address inappropriate prescribing including greater prescribing of Access antibiotics where pertinent.
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Affiliation(s)
- Zia Ul Mustafa
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
- Department of Pharmacy Services, District Headquarter (DHQ) Hospital, Pakpattan, Pakistan
| | - Arfa Batool
- Department of Medicine, Sheikh Zaid Medical College, Rahim Yar Khan, Pakistan
| | - Hadia Ibrar
- Department of Medicine, Wah Medical College, Rawalpindi, Pakistan
| | - Muhammad Salman
- Institute of Pharmacy, Faculty of Pharmaceutical and Allied Health Sciences, Lahore College for Women University, Lahore, Pakistan
| | - Yusra Habib Khan
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Saudi Arabia
| | - Tauqeer Hussain Mallhi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Saudi Arabia
| | - Johanna C Meyer
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa
- South African Vaccination and Immunisation Centre, Sefako Makgatho Health Sciences University, Garankuwa, Pretoria, South Africa
| | - Brian Godman
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa
- Strathclyde Institute of Pharmacy and Biomedical Science (SIPBS), University of Strathclyde, Glasgow, UK
| | - Catrin E Moore
- Centre for Neonatal and Pediatric Infection, St. George's University of London, London, UK
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Zhu C, Pang S, Liu J, Duan Q. Current Progress, Challenges and Prospects in the Development of COVID-19 Vaccines. Drugs 2024; 84:403-423. [PMID: 38652356 DOI: 10.1007/s40265-024-02013-8] [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] [Accepted: 02/25/2024] [Indexed: 04/25/2024]
Abstract
The COVID-19 pandemic has resulted in over 772 million confirmed cases, including nearly 7 million deaths, according to the World Health Organization (WHO). Leveraging rapid development, accelerated vaccine approval processes, and large-scale production of various COVID-19 vaccines using different technical platforms, the WHO declared an end to the global health emergency of COVID-19 on May 5, 2023. Current COVID-19 vaccines encompass inactivated, live attenuated, viral vector, protein subunit, nucleic acid (DNA and RNA), and virus-like particle (VLP) vaccines. However, the efficacy of these vaccines is diminishing due to the constant mutation of SARS-CoV-2 and the heightened immune evasion abilities of emerging variants. This review examines the impact of the COVID-19 pandemic, the biological characteristics of the virus, and its diverse variants. Moreover, the review underscores the effectiveness, advantages, and disadvantages of authorized COVID-19 vaccines. Additionally, it analyzes the challenges, strategies, and future prospects of developing a safe, broad-spectrum vaccine that confers sufficient and sustainable immune protection against new variants of SARS-CoV-2. These discussions not only offer insight for the development of next-generation COVID-19 vaccines but also summarize experiences for combating future emerging viruses.
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Affiliation(s)
- Congrui Zhu
- Guangdong Laboratory of Lingnan Modern Agriculture, Guangdong Provincial Key Laboratory of Animal Nutrition Control, State Key Laboratory of Swine and Poultry Breeding Industry, College of Animal Science, South China Agricultural University, Guangzhou, 510000, China
| | - Shengmei Pang
- Department of Veterinary Microbiology, College of Veterinary Medicine, Yangzhou University, Yangzhou, 225009, China
- Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, 225009, China
- Jiangsu Joint Laboratory for International Cooperation in Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, 225009, China
| | - Jiaqi Liu
- Department of Veterinary Microbiology, College of Veterinary Medicine, Yangzhou University, Yangzhou, 225009, China
- Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, 225009, China
- Jiangsu Joint Laboratory for International Cooperation in Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, 225009, China
| | - Qiangde Duan
- Department of Veterinary Microbiology, College of Veterinary Medicine, Yangzhou University, Yangzhou, 225009, China.
- Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, 225009, China.
- Jiangsu Joint Laboratory for International Cooperation in Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, 225009, China.
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Fan S, Mo X, Zhang X, Xu L, Wang Y, Yan C, Chen H, Zhang Y, Cheng Y, Sun Y, Chen Y, Chen Y, Han W, Wang J, Wang F, Xu Z, Huang X. Clinical characteristics and outcomes of allogeneic hematopoietic stem cell transplantation recipients with coronavirus disease 2019 caused by the Omicron variant: a prospective, observational cohort study. Ann Hematol 2024; 103:1333-1344. [PMID: 38381172 DOI: 10.1007/s00277-024-05653-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 02/05/2024] [Indexed: 02/22/2024]
Abstract
We aimed to describe the clinical characteristics, particularly the occurrence and risk factors of severe/critical illness, in allogeneic hematopoietic stem cell (allo-HSCT) recipients infected with coronavirus disease 2019 (COVID-19) caused by Omicron variant in an observational prospective study (n = 311). The median time from allo-HSCT to COVID-19 diagnosis was 8.5 months (range 0.8-106.1) months. Four patients (1.3%) were reported to be asymptomatic during Omicron variant infection, and 135 (43.4%) patients showed lower respiratory tract disease. Thirty-four (10.9%) patients were categorized into serious infection (severe illness n = 25; critical illness n = 9) and the median duration from COVID-19 diagnosis to serious infections was 6 days (range, 0-29) days. Thirteen (4.2%) and 6 (1.9%) patients required intensive care unit care and invasive mechanical ventilation, respectively. Receiving more than 1 type of immunosuppressive therapies at COVID-19 diagnosis was associated with severity and persistence of infection. Six patients (1.9%) died after diagnosis of COVID-19 infection. The 4-week probability of overall survival after COVID-19 diagnosis was 98.7%, which was 100% and 88.2% for non-serious and serious infection group (P < 0.001), respectively. Thus, we observed a relatively low serious infection and mortality rate in allo-HSCT recipients infected with COVID-19 caused by Omicron variant.
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Affiliation(s)
- Shuang Fan
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Xiaodong Mo
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
- Research Unit of Key Technique for Diagnosis and Treatments of Hematologic Malignancies, Chinese Academy of Medical Sciences, Beijing, 2019RU029, China
| | - Xiaohui Zhang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - LanPing Xu
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Yu Wang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Chenhua Yan
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Huan Chen
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Yuanyuan Zhang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Yifei Cheng
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Yuqian Sun
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Yuhong Chen
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Yao Chen
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Wei Han
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Jingzhi Wang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Fengrong Wang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Zhengli Xu
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Xiaojun Huang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
- Research Unit of Key Technique for Diagnosis and Treatments of Hematologic Malignancies, Chinese Academy of Medical Sciences, Beijing, 2019RU029, China.
- Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China.
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Ahmed SAE, AbuKoura R, Ahmed AE, Abdalla O, Hassan OK, Tom A, Eldirdiri A, Ismaeil D, Zainalabdeen I, Nurelhuda N, Ahmed A, Abdan A, Dahab M, Abdelmagid N. Changes in social mixing and attitudes and practices to precautionary measures in a maturing COVID-19 pandemic in six communities in Sudan: a qualitative study. BMC Public Health 2024; 24:895. [PMID: 38532360 PMCID: PMC10964503 DOI: 10.1186/s12889-024-18274-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 03/04/2024] [Indexed: 03/28/2024] Open
Abstract
INTRODUCTION With low COVID-19 vaccination coverage, non-pharmaceutical interventions were critical to mitigating the COVID-19 pandemic in Sudan. We explored changes in social contact patterns, risk perception, attitudes, and practices toward protective measures during an evolving COVID-19 outbreak in six illustrative communities in Sudan. METHODS This qualitative study took place in six communities in five Sudanese states using focus group discussions with community members and non-participant structured observations in public spaces between March 2021 and April 2021. A total of 117 participants joined 24 group discussions. We used a two-stage thematic analysis. RESULTS The perceived importance of compliance with individual preventative measures among those who believe in COVID-19 was higher than observed compliance with behaviors in most study sites. Adherence was consistently low and mainly driven by enforced movement restrictions. As restrictions were lifted, social contacts outside the household resumed pre-COVID-19 levels, and risk perception and individual and institutional adherence to protective measures diminished. We identified an environment that is socially and economically unsupportive of preventive practices, compounded by widespread rumours, misinformation, and mistrust in the government-led response. However, we identified new social habits that can contribute to reducing COVID-19 transmission. CONCLUSION The unfavourable social and economic environment, coupled with the low visibility of the pandemic and pandemic response, has likely modulated the influence of higher risk perception on adopting precautionary behaviours by individuals. Governments and non-governmental actors should increase the visibility of the pandemic and pandemic response, enforce and incentivise infection control measures in public areas, promote emerging preventive social habits, and actively track and address rumours and misinformation related to COVID-19 and COVID-19 vaccines.
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Affiliation(s)
- Salma A E Ahmed
- Independent public health researcher, Khartoum, Sudan.
- Sudan COVID-19 Research Group, Khartoum, Sudan.
| | - Rahaf AbuKoura
- London School of Hygiene and Tropical Medicine, Department of Infectious Disease Epidemiology, London, UK
- Sudan COVID-19 Research Group, Khartoum, Sudan
| | - Abd Elhameed Ahmed
- Y-PEER Sudan, Khartoum, Sudan
- Sudan COVID-19 Research Group, Khartoum, Sudan
| | - Omama Abdalla
- Y-PEER Sudan, Khartoum, Sudan
- Sudan COVID-19 Research Group, Khartoum, Sudan
| | - Omnia Kamal Hassan
- Y-PEER Sudan, Khartoum, Sudan
- Sudan COVID-19 Research Group, Khartoum, Sudan
| | - Ahmed Tom
- Y-PEER Sudan, Khartoum, Sudan
- Sudan COVID-19 Research Group, Khartoum, Sudan
| | - Ahmed Eldirdiri
- Y-PEER Sudan, Khartoum, Sudan
- Sudan COVID-19 Research Group, Khartoum, Sudan
| | - Drieg Ismaeil
- Y-PEER Sudan, Khartoum, Sudan
- Sudan COVID-19 Research Group, Khartoum, Sudan
| | - Israa Zainalabdeen
- Y-PEER Sudan, Khartoum, Sudan
- Sudan COVID-19 Research Group, Khartoum, Sudan
| | - Nazik Nurelhuda
- University of Khartoum, Khartoum, Sudan
- Sudan COVID-19 Research Group, Khartoum, Sudan
| | - Aljaile Ahmed
- Y-PEER Sudan, Khartoum, Sudan
- Sudan COVID-19 Research Group, Khartoum, Sudan
| | - Afrah Abdan
- The Federal Ministry of Health, Khartoum, Sudan
| | - Maysoon Dahab
- London School of Hygiene and Tropical Medicine, Department of Infectious Disease Epidemiology, London, UK
- Sudan COVID-19 Research Group, Khartoum, Sudan
| | - Nada Abdelmagid
- London School of Hygiene and Tropical Medicine, Department of Infectious Disease Epidemiology, London, UK
- Sudan COVID-19 Research Group, Khartoum, Sudan
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Charles CM, Noles M, Munezero A, Gallardo N, Bahamondes L, Bento SF, de Pádua KS, Nhauche M, Metelus S, Cecatti JG, Souza RT, Pacagnella RC. Risk factors related to the SARS-CoV-2 vaccine additional doses hesitancy among pregnant and non-pregnant people of reproductive age and partners: A Brazilian cross-sectional study. Int J Gynaecol Obstet 2024. [PMID: 38532554 DOI: 10.1002/ijgo.15512] [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: 01/26/2024] [Revised: 03/09/2024] [Accepted: 03/18/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVE The aim of this study was to assess the predictors of acceptance and hesitancy of additional doses of any SARS-CoV-2 (COVID-19) vaccine among pregnant or recently pregnant and non-pregnant people of reproductive age and partners in Brazil. METHODS We conducted an online cross-sectional study from June 2022 to April 2023 and invited women and partners between 18 and 49 years old to participate. We employed a snowball strategy to reach all potential eligible participants. Our primary outcome was the acceptance rate of the COVID-19 booster vaccine. We estimated the frequency and percentage for the three groups and compared categorical variables using the Chi-square test. Moreover, bivariate, backward stepwise regression, and subgroup analyses were performed to evaluate risk factors and predictors of COVID-19 vaccine booster hesitancy. We reported the effect size as OR with a 95% CI. RESULTS We included 1487 participants, and among them, 334 (22.5%) were pregnant or recently pregnant people, 905 (60.8%) were non-pregnant people, and 247 (16.6%) were male partners. Pregnant and recently pregnant people showed greater hesitancy for the COVID-19 vaccine booster than non-pregnant people (28% vs 15%, P < 0.001) and male partners (28% vs 16%, P < 0.001). Non-pregnant women accepted the COVID-19 vaccine more often than pregnant or recently pregnant people (OR 1.75; 95% CI: 1.13-2.70). The associated factors to the reduced COVID-19 vaccine booster acceptance were family income between US$ 566-945.00 (54%), evangelic religion (65%), concern about vaccine safety (80%) and perceived common vaccine importance (93%). CONCLUSION Pregnant people were more hesitant than non-pregnant people to accept the COVID-19 booster vaccine. Family income, religious beliefs, vaccine safety concerns, and perceived common vaccine importance were significant barriers to accepting COVID-19 booster vaccines. The impact of these factors was more evident among pregnant or recently pregnant people, emphasizing the harmful effect of misinformation among this vulnerable population.
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Affiliation(s)
- Charles M Charles
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
- Provincial Health Administration, DPS Manica, Chimoio, Mozambique
| | - Marcelo Noles
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
| | - Aline Munezero
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
| | - Negli Gallardo
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
| | - Luis Bahamondes
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
- Campinas Reproductive Health Research Center (CEMICAMP), Campinas, Brazil
| | - Silvana F Bento
- Campinas Reproductive Health Research Center (CEMICAMP), Campinas, Brazil
- Women's Hospital "Prof. Dr. José A Pinotti" - Center for Integral Attention to Women (CAISM), Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Karla S de Pádua
- Campinas Reproductive Health Research Center (CEMICAMP), Campinas, Brazil
- Women's Hospital "Prof. Dr. José A Pinotti" - Center for Integral Attention to Women (CAISM), Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Marta Nhauche
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
| | - Sherly Metelus
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
| | - José G Cecatti
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
- Campinas Reproductive Health Research Center (CEMICAMP), Campinas, Brazil
| | - Renato T Souza
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
- Campinas Reproductive Health Research Center (CEMICAMP), Campinas, Brazil
| | - Rodolfo C Pacagnella
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
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Ahmed F, Shafer L, Malla P, Hopkins R, Moreland S, Zviedrite N, Uzicanin A. Systematic review of empiric studies on lockdowns, workplace closures, and other non-pharmaceutical interventions in non-healthcare workplaces during the initial year of the COVID-19 pandemic: benefits and selected unintended consequences. BMC Public Health 2024; 24:884. [PMID: 38519891 PMCID: PMC10960383 DOI: 10.1186/s12889-024-18377-1] [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: 04/05/2023] [Accepted: 03/17/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND We conducted a systematic review aimed to evaluate the effects of non-pharmaceutical interventions within non-healthcare workplaces and community-level workplace closures and lockdowns on COVID-19 morbidity and mortality, selected mental disorders, and employment outcomes in workers or the general population. METHODS The inclusion criteria included randomized controlled trials and non-randomized studies of interventions. The exclusion criteria included modeling studies. Electronic searches were conducted using MEDLINE, Embase, and other databases from January 1, 2020, through May 11, 2021. Risk of bias was assessed using the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) tool. Meta-analysis and sign tests were performed. RESULTS A total of 60 observational studies met the inclusion criteria. There were 40 studies on COVID-19 outcomes, 15 on anxiety and depression symptoms, and five on unemployment and labor force participation. There was a paucity of studies on physical distancing, physical barriers, and symptom and temperature screening within workplaces. The sign test indicated that lockdown reduced COVID-19 incidence or case growth rate (23 studies, p < 0.001), reproduction number (11 studies, p < 0.001), and COVID-19 mortality or death growth rate (seven studies, p < 0.05) in the general population. Lockdown did not have any effect on anxiety symptoms (pooled standardized mean difference = -0.02, 95% CI: -0.06, 0.02). Lockdown had a small effect on increasing depression symptoms (pooled standardized mean difference = 0.16, 95% CI: 0.10, 0.21), but publication bias could account for the observed effect. Lockdown increased unemployment (pooled mean difference = 4.48 percentage points, 95% CI: 1.79, 7.17) and decreased labor force participation (pooled mean difference = -2.46 percentage points, 95% CI: -3.16, -1.77). The risk of bias for most of the studies on COVID-19 or employment outcomes was moderate or serious. The risk of bias for the studies on anxiety or depression symptoms was serious or critical. CONCLUSIONS Empiric studies indicated that lockdown reduced the impact of COVID-19, but that it had notable unwanted effects. There is a pronounced paucity of studies on the effect of interventions within still-open workplaces. It is important for countries that implement lockdown in future pandemics to consider strategies to mitigate these unintended consequences. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration # CRD42020182660.
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Affiliation(s)
- Faruque Ahmed
- Division of Global Migration Health, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop V18-2, Atlanta, GA, 30329-4027, USA.
| | - Livvy Shafer
- Division of Global Migration Health, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop V18-2, Atlanta, GA, 30329-4027, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Pallavi Malla
- Division of Global Migration Health, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop V18-2, Atlanta, GA, 30329-4027, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Roderick Hopkins
- Division of Global Migration Health, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop V18-2, Atlanta, GA, 30329-4027, USA
- Cherokee Nation Operational Solutions, Tulsa, OK, USA
| | - Sarah Moreland
- Division of Global Migration Health, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop V18-2, Atlanta, GA, 30329-4027, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Nicole Zviedrite
- Division of Global Migration Health, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop V18-2, Atlanta, GA, 30329-4027, USA
| | - Amra Uzicanin
- Division of Global Migration Health, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop V18-2, Atlanta, GA, 30329-4027, USA
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Wollast R, Schmitz M, Bigot A, Brisbois M, Luminet O. Predicting health behaviors during the COVID-19 pandemic: A longitudinal study. PLoS One 2024; 19:e0299868. [PMID: 38489308 PMCID: PMC10942062 DOI: 10.1371/journal.pone.0299868] [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: 09/28/2023] [Accepted: 02/16/2024] [Indexed: 03/17/2024] Open
Abstract
We investigated the social, emotional, and cognitive predictors of adherence to four health behaviors (handwashing, mask wearing, social contact limitations, and physical distancing) during one critical phase of the COVID-19 pandemic. We collected data (N = 5803, mean age = 53; 57% women) in Belgium at five time points between April and July 2021, a time during which infections evolved from high (third wave of the pandemic) to low numbers of COVID-19 cases. The results show that the social, emotional, and cognitive predictors achieved high levels of explained variance (R2 > .60). In particular, the central components of behavioral change (attitudes, intentions, control, habits, norms, and risk) were the strongest and most consistent predictors of health behaviors over time. Likewise, autonomous motivation and empathetic emotions (e.g., attentive, compassionate) had a positive impact on health behavior adherence, whereas it was the opposite for lively emotions (e.g., active, enthusiastic). These results offer policymakers actionable insights into the most potent and stable factors associated with health behaviors, equipping them with effective strategies to curtail the spread of future infectious diseases.
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Affiliation(s)
- Robin Wollast
- Research Institute for Psychological Sciences, UCLouvain, Ottignies-Louvain-la-Neuve, Belgium
| | - Mathias Schmitz
- Research Institute for Psychological Sciences, UCLouvain, Ottignies-Louvain-la-Neuve, Belgium
| | - Alix Bigot
- Research Institute for Psychological Sciences, UCLouvain, Ottignies-Louvain-la-Neuve, Belgium
| | - Marie Brisbois
- Faculty of Psychological Sciences and Education, Université libre de Bruxelles, Bruxelles, Belgium
| | - Olivier Luminet
- Research Institute for Psychological Sciences, UCLouvain, Ottignies-Louvain-la-Neuve, Belgium
- Fund for Scientific Research (FRS-FNRS), Brussels, Belgium
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Fontaine G, Smith M, Langmuir T, Mekki K, Ghazal H, Noad EE, Buchan J, Dubey V, Patey AM, McCleary N, Gibson E, Wilson M, Alghamyan A, Zmytrovych K, Thompson K, Crawshaw J, Grimshaw JM, Arnason T, Brehaut J, Michie S, Brouwers M, Presseau J. One size doesn't fit all: methodological reflections in conducting community-based behavioural science research to tailor COVID-19 vaccination initiatives for public health priority populations. BMC Public Health 2024; 24:784. [PMID: 38481197 PMCID: PMC10936009 DOI: 10.1186/s12889-024-18270-x] [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: 12/11/2023] [Accepted: 03/04/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Promoting the uptake of vaccination for infectious diseases such as COVID-19 remains a global challenge, necessitating collaborative efforts between public health units (PHUs) and communities. Applied behavioural science can play a crucial role in supporting PHUs' response by providing insights into human behaviour and informing tailored strategies to enhance vaccination uptake. Community engagement can help broaden the reach of behavioural science research by involving a more diverse range of populations and ensuring that strategies better represent the needs of specific communities. We developed and applied an approach to conducting community-based behavioural science research with ethnically and socioeconomically diverse populations to guide PHUs in tailoring their strategies to promote COVID-19 vaccination. This paper presents the community engagement methodology and the lessons learned in applying the methodology. METHODS The community engagement methodology was developed based on integrated knowledge translation (iKT) and community-based participatory research (CBPR) principles. The study involved collaboration with PHUs and local communities in Ontario, Canada to identify priority groups for COVID-19 vaccination, understand factors influencing vaccine uptake and co-design strategies tailored to each community to promote vaccination. Community engagement was conducted across three large urban regions with individuals from Eastern European communities, African, Black, and Caribbean communities and low socioeconomic neighbourhoods. RESULTS We developed and applied a seven-step methodology for conducting community-based behavioural science research: (1) aligning goals with system-level partners; (2) engaging with PHUs to understand priorities; (3) understanding community strengths and dynamics; (4) building relationships with each community; (5) establishing partnerships (community advisory groups); (6) involving community members in the research process; and (7) feeding back and interpreting research findings. Research partnerships were successfully established with members of prioritized communities, enabling recruitment of participants for theory-informed behavioural science interviews, interpretation of findings, and co-design of targeted recommendations for each PHU to improve COVID-19 vaccination uptake. Lessons learned include the importance of cultural sensitivity and awareness of sociopolitical context in tailoring community engagement, being agile to address the diverse and evolving priorities of PHUs, and building trust to achieve effective community engagement. CONCLUSION Effective community engagement in behavioural science research can lead to more inclusive and representative research. The community engagement approach developed and applied in this study acknowledges the diversity of communities, recognizes the central role of PHUs, and can help in addressing complex public health challenges.
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Affiliation(s)
- Guillaume Fontaine
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada
- Department of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON, K1H 8M5, Canada
| | | | - Tori Langmuir
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada
| | - Karim Mekki
- Ottawa Public Health, 100 Constellation Dr, Nepean, ON, K2G 6J8, Canada
| | - Hanan Ghazal
- Ottawa Public Health, 100 Constellation Dr, Nepean, ON, K2G 6J8, Canada
| | | | - Judy Buchan
- Peel Public Health, 7120 Hurontario St, Mississauga, ON, L5W 1N4, Canada
| | - Vinita Dubey
- Toronto Public Health, City Hall, 100 Queen St W, Toronto, ON, M5H 2N2, Canada
| | - Andrea M Patey
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada
- School of Epidemiology and Public Health, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada
- School of Rehabilitation Therapy, Queen's University, Louise D Acton Building, 31 George St, Kingston, ON, K7L 3N6, Canada
| | - Nicola McCleary
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada
| | - Emily Gibson
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada
| | - Mackenzie Wilson
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada
| | | | | | | | - Jacob Crawshaw
- McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Jeremy M Grimshaw
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada
- Department of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON, K1H 8M5, Canada
- School of Epidemiology and Public Health, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada
| | - Trevor Arnason
- Ottawa Public Health, 100 Constellation Dr, Nepean, ON, K2G 6J8, Canada
| | - Jamie Brehaut
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada
- School of Epidemiology and Public Health, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada
| | - Susan Michie
- Centre for Behaviour Change, University College London, Gower St, London, WC1E 6BT, UK
| | - Melissa Brouwers
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada
- School of Epidemiology and Public Health, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada
| | - Justin Presseau
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada.
- School of Epidemiology and Public Health, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada.
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier Vanier Hall, Ottawa, ON, K1N 6N5, Canada.
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Zhu DT, Hawken S, Serhan M, Graves F, Smith J, Wilson K. Public attitudes towards COVID-19 vaccine mandates and vaccine certificates in Canada: a time series study. Arch Public Health 2024; 82:32. [PMID: 38468303 PMCID: PMC10926625 DOI: 10.1186/s13690-024-01259-8] [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: 11/22/2023] [Accepted: 02/25/2024] [Indexed: 03/13/2024] Open
Abstract
INTRODUCTION Since the beginning of the pandemic, numerous public health measures such as COVID-19 vaccines, vaccine mandates and vaccination certificates have been introduced to mitigate the spread of COVID-19. Public opinion and attitudes towards these measures have fluctuated in response to the dynamic political, social, and cultural landscape of the pandemic. METHODS We conducted a time-series study consisting of national cross-sectional surveys between November 2021 to March 2022 to evaluate the Canadian public's attitudes towards COVID-19 vaccine mandates and vaccine certificates. RESULTS When examining public sentiment towards COVID-19 vaccine certificates and proof of vaccination measures, there was a shift in responses over time. The proportion of participants "strongly supporting" these measures decreased from 66.0 to 43.1% between W25(Capacity Limits), -W32 (Mask Mandate Removed), whereas "strongly oppose" was the second most common response and rose from 15.9 to 20.6% during this same time period. Concurrently, when examining participants views surrounding mandates, many participants believed that their province was reopening at "about the right pace", which remained relatively stable over time (33.0-35.4%) between W28 (Emergency Act)-W32 (Mask Mandate Removed). CONCLUSION Our study's findings on the public's attitudes towards COVID-19 vaccine mandates and vaccine certificates in Canada may aid to guide and streamline the implementation of future similar public health interventions. Future research should include extended follow-up and a more comprehensive examination of trust in government institutions and polarized perspectives on vaccine mandates.
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Affiliation(s)
- David T Zhu
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Virginia Commonwealth School of Medicine, Richmond, VA, USA
| | - Steven Hawken
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Mohamed Serhan
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Frank Graves
- EKOS Research Associates Inc., Ottawa, ON, Canada
| | - Jeff Smith
- EKOS Research Associates Inc., Ottawa, ON, Canada
| | - Kumanan Wilson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada.
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
- Bruyère Research Institute, Ottawa, ON, Canada.
- O'Neill Institute for National and Global Health Law, Georgetown University, Washington, D.C, USA.
- Ottawa Hospital, Civic Campus, Administrative Services Building, 1053 Carling Avenue, Box 684, Ottawa, Ontario, K1Y 4E9, Canada.
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Minehmorad M, Nemati-Vakilabad R, Badpeyma M, Mirzaei A. Examining nurses' understanding and knowledge about preparation for COVID-19 in Ardabil hospitals in Iran. BMC Health Serv Res 2024; 24:312. [PMID: 38454446 PMCID: PMC10921800 DOI: 10.1186/s12913-024-10826-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 03/05/2024] [Indexed: 03/09/2024] Open
Abstract
AIMS The purpose of this study was to evaluate the preparedness of Iranian nurses for potential pandemics. BACKGROUND Nurses play a critical role in managing pandemics. They require adequate training, proper equipment, and organizational support to be well-prepared. METHODS A descriptive cross-sectional study was conducted in Ardabil, Iran, from July to September 2023, involving 233 nurses from five hospitals. The number of nurses required for each hospital was calculated based on the proportion of nurses in each hospital. Data was collected through a paper-based form that included information about the participants' demographic characteristics and their level of pandemic preparedness in health services. The collected data was analyzed using descriptive statistics to determine the demographic characteristics and levels of pandemic preparedness. Pearson's test was also conducted to establish a relationship between different dimensions of pandemic preparedness. RESULTS Most participants relied on clinical measures and supported using human resources and environmental methods to curb the transmission of a pandemic. They felt assured in their ability to explain the preventive measures against the pandemic. However, fewer respondents had access to healthcare improvement programs, and only a few worked remotely from home. CONCLUSIONS According to our study, 90.1% of nurses believe hand washing is the most effective way to prevent spreading infections. Additionally, healthcare professionals can use various tools to respond to the pandemic, including screening for COVID-19 at work, health and wellness programs, telecommuting, COVID-19 Safe programs, social media, and posters. Nurses need continuous education in hand hygiene, health programs, remote work options, and pandemic-safe programs to control infections, reduce risks, and optimize patient care during the pandemic.
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Affiliation(s)
- Milad Minehmorad
- Students Research Committee, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Reza Nemati-Vakilabad
- Students Research Committee, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
- Student Research Committee, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Badpeyma
- Students Research Committee, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Alireza Mirzaei
- Department of Emergency Nursing, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran.
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Navarro Y, Huang E, Johnson C, Clark F, Coppola S, Modi S, Warren GL, Call JA. The Influence of COVID-19 on Patient Mobilization and Injury Attributes in the ICU: A Retrospective Analysis of a Level II Trauma Center. TRAUMA CARE 2024; 4:44-59. [PMID: 38606188 PMCID: PMC11007754 DOI: 10.3390/traumacare4010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024] Open
Abstract
The objectives of this study were to determine the effect of COVID-19 on physical therapy (PT) mobilization of trauma patients and to determine if mobilization affected patient course in the ICU. This retrospective study included patients who were admitted to the ICU of a level II trauma center. The patients were divided into two groups, i.e., those admitted before (n = 378) and after (n = 499) 1 April 2020 when Georgia's COVID-19 shelter-in-place order was mandated. The two groups were contrasted on nominal and ratio variables using Chi-square and Student's t-tests. A secondary analysis focused specifically on the after-COVID patients examined the extent to which mobilization (n = 328) or lack of mobilization (n = 171) influenced ICU outcomes (e.g., mortality, readmission). The two groups were contrasted on nominal and ratio variables using Chi-square and Student's t-tests. The after-COVID patients had higher injury severity as a greater proportion was classified as severely injured (i.e., >15 on Injury Severity Score) compared to the before-COVID patients. After-COVID patients also had a greater cumulative number of comorbidities and experienced greater complications in the ICU. Despite this, there was no difference between patients in receiving a PT consultation or days to mobilization. Within the after-COVID cohort, those who were mobilized were older, had greater Glasgow Coma Scale scores, had longer total hospital days, and had a lesser mortality rate, and a higher proportion were female. Despite shifting patient injury attributes post-COVID-19, a communicable disease, mobilization care remained consistent and effective.
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Affiliation(s)
- Yelissa Navarro
- Medical College of Georgia, AU/UGA Medical Partnership, Athens, GA 30602, USA
| | - Elizabeth Huang
- Medical College of Georgia, AU/UGA Medical Partnership, Athens, GA 30602, USA
| | - Chandler Johnson
- Medical College of Georgia, AU/UGA Medical Partnership, Athens, GA 30602, USA
| | - Forrest Clark
- Medical College of Georgia, AU/UGA Medical Partnership, Athens, GA 30602, USA
| | - Samuel Coppola
- Medical College of Georgia, AU/UGA Medical Partnership, Athens, GA 30602, USA
| | - Suraj Modi
- Medical College of Georgia, AU/UGA Medical Partnership, Athens, GA 30602, USA
| | - Gordon L. Warren
- Department of Physical Therapy, Georgia State University, Atlanta, GA 30302, USA
| | - Jarrod A. Call
- Department of Physiology & Pharmacology, University of Georgia, Athens, GA 30602, USA
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Yang W, Shaman J. Reconciling the efficacy and effectiveness of masking on epidemic outcomes. J R Soc Interface 2024; 21:20230666. [PMID: 38442856 PMCID: PMC10914508 DOI: 10.1098/rsif.2023.0666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 02/07/2024] [Indexed: 03/07/2024] Open
Abstract
During the COVID-19 pandemic, mask wearing in public settings has been a key control measure. However, the reported effectiveness of masking has been much lower than laboratory measures of efficacy, leading to doubts on the utility of masking. Here, we develop an agent-based model that comprehensively accounts for individual masking behaviours and infectious disease dynamics, and test the impact of masking on epidemic outcomes. Using realistic inputs of mask efficacy and contact data at the individual level, the model reproduces the lower effectiveness as reported in randomized controlled trials. Model results demonstrate that transmission within households, where masks are rarely used, can substantially lower effectiveness, and reveal the interaction of nonlinear epidemic dynamics, control measures and potential measurement biases. Overall, model results show that, at the individual level, consistent masking can reduce the risk of first infection and, over time, reduce the frequency of repeated infection. At the population level, masking can provide direct protection to mask wearers, as well as indirect protection to non-wearers, collectively reducing epidemic intensity. These findings suggest it is prudent for individuals to use masks during an epidemic, and for policymakers to recognize the less-than-ideal effectiveness of masking when devising public health interventions.
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Affiliation(s)
- Wan Yang
- Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA
| | - Jeffrey Shaman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA
- Columbia Climate School, Columbia University, New York, NY, USA
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Lawrence A. Evaluating the Effectiveness of Public Health Measures During Infectious Disease Outbreaks: A Systematic Review. Cureus 2024; 16:e55893. [PMID: 38595888 PMCID: PMC11003486 DOI: 10.7759/cureus.55893] [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] [Accepted: 03/10/2024] [Indexed: 04/11/2024] Open
Abstract
Over the previous three decades, the incidence of infectious disease outbreaks has considerably increased and the trend is expected to increase further. Public health measures are essential for controlling and preventing emerging outbreaks of infectious illnesses. This study is aimed at evaluating the effectiveness of public health measures during infectious disease outbreaks by summarizing the outcomes from the available evidence in the literature. A systematic review was carried out through a detailed search strategy using specific keywords applied across different electronic databases, including the Science Direct, PubMed, and EMBASE databases. Studies published between 2015 and 2024 were included with a focus on cohorts, clinical trials, longitudinal studies, case-control, and quasi-experimental studies. Low-quality studies and those published before 2015 along with incorrect findings or measures were excluded. A standardized form was used for data extraction. The quality of included studies and the risk of bias were assessed through relevant techniques. The obtained data was narrative synthesized and findings were organized systematically. The reviewed studies revealed that public health measures are considerably effective against infectious disease outbreaks. The success of various measures such as social isolation, confinement measures, and public education on hygiene against different outbreaks of respiratory infectious diseases has been well-established in the literature. Moreover, the timing of intervention application plays a vital role in their success. The implementation in the early phase of an outbreak is highly effective, as it protects more people from infection and controls the overall burden of the disease. The systematic review provided valuable insights into the efficiency of public health measures in monitoring outbreaks of infectious illnesses. The main findings suggest that appropriate public health interventions are effective in controlling the incidence of contagious disease outbreaks. Ongoing research strives to investigate measures that are most effective from the perspective of public health against various transmittable diseases to prevent future outbreaks.
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Affiliation(s)
- Adewale Lawrence
- Pharmaceutical Medicine, Bioluminux Clinical Research, Naperville, USA
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Nourouzpour N, Jen TTH, Bailey J, Jobin PG, Sutherland JM, Ho CM, Prabhakar C, Ke JXC. Association between anesthesia technique and death after hip fracture repair for patients with COVID-19. Can J Anaesth 2024; 71:367-377. [PMID: 38129357 DOI: 10.1007/s12630-023-02673-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/26/2023] [Accepted: 09/18/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE Patients with COVID-19 undergoing hip fracture surgeries have a 30-day mortality of up to 34%. We aimed to evaluate the association between anesthesia technique and 30-day mortality after hip fracture surgery in patients with COVID-19. METHODS After ethics approval, we performed a retrospective cohort analysis of the American College of Surgeons National Surgical Quality Improvement Program data set from January to December 2021. Inclusion criteria were age ≥ 19 yr, laboratory-confirmed SARS-CoV-2 infection within 14 days preoperatively, and hip fracture surgery under general anesthesia (GA) or spinal anesthesia (SA). Exclusion criteria were American Society of Anesthesiologists Physical Status V, ventilator dependence, international normalized ratio ≥ 1.5, partial thromboplastin time > 35 sec, and platelet count < 80 × 109 L-1. The primary outcome was all-cause 30-day mortality. The adjusted association between anesthetic technique and 30-day mortality was analyzed using multivariable logistic regression. RESULTS Of 23,045 patients undergoing hip fracture surgery, 331 patients met the study criteria. The median [interquartile range] age was 82 [74-88] yr, and 32.3% were male. The 30-day mortality rate was 10.0% (33/331) for the cohort (10.7%, 29/272 for GA vs 6.8%, 4/59 for SA; P = 0.51; standardized mean difference, 0.138). The use of SA, compared with GA, was not associated with decreased mortality (adjusted odds ratio, 0.61; 95% confidence interval, 0.21 to 1.8; E-value, 2.49). CONCLUSION Anesthesia technique was not associated with mortality in patients with COVID-19 undergoing hip fracture surgery. The findings were limited by a small sample size. STUDY REGISTRATION www. CLINICALTRIALS gov (NCT05133648); registered 24 November 2021.
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Affiliation(s)
- Nilufer Nourouzpour
- Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
- Department of Anesthesiology, Pharmacology & Therapeutics, The University of British Columbia, Vancouver, BC, Canada
| | - Tim T H Jen
- Department of Anesthesiology, Pharmacology & Therapeutics, The University of British Columbia, Vancouver, BC, Canada
- Department of Anesthesia, St. Paul's Hospital, Providence Health Care, Vancouver, BC, Canada
| | - Jonathan Bailey
- Department of Anesthesiology, Pain Management, and Perioperative Medicine, Dalhousie University, Halifax, NS, Canada
| | - Parker G Jobin
- Department of Medicine, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Jason M Sutherland
- Centre for Health Services and Policy Research, School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
| | - Chun-Man Ho
- Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Christopher Prabhakar
- Department of Anesthesiology, Pharmacology & Therapeutics, The University of British Columbia, Vancouver, BC, Canada
- Department of Anesthesia, St. Paul's Hospital, Providence Health Care, Vancouver, BC, Canada
| | - Janny X C Ke
- Department of Anesthesiology, Pharmacology & Therapeutics, The University of British Columbia, Vancouver, BC, Canada.
- Department of Anesthesiology, Pain Management, and Perioperative Medicine, Dalhousie University, Halifax, NS, Canada.
- Department of Anesthesia, St. Paul's Hospital, Providence Health Care, Third Floor, Providence Building, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
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Ganser I, Buckeridge DL, Heffernan J, Prague M, Thiébaut R. Estimating the population effectiveness of interventions against COVID-19 in France: A modelling study. Epidemics 2024; 46:100744. [PMID: 38324970 DOI: 10.1016/j.epidem.2024.100744] [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: 08/07/2023] [Revised: 12/12/2023] [Accepted: 01/22/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Non-pharmaceutical interventions (NPIs) and vaccines have been widely used to manage the COVID-19 pandemic. However, uncertainty persists regarding the effectiveness of these interventions due to data quality issues, methodological challenges, and differing contextual factors. Accurate estimation of their effects is crucial for future epidemic preparedness. METHODS To address this, we developed a population-based mechanistic model that includes the impact of NPIs and vaccines on SARS-CoV-2 transmission and hospitalization rates. Our statistical approach estimated all parameters in one step, accurately propagating uncertainty. We fitted the model to comprehensive epidemiological data in France from March 2020 to October 2021. With the same model, we simulated scenarios of vaccine rollout. RESULTS The first lockdown was the most effective, reducing transmission by 84 % (95 % confidence interval (CI) 83-85). Subsequent lockdowns had diminished effectiveness (reduction of 74 % (69-77) and 11 % (9-18), respectively). A 6 pm curfew was more effective than one at 8 pm (68 % (66-69) vs. 48 % (45-49) reduction), while school closures reduced transmission by 15 % (12-18). In a scenario without vaccines before November 2021, we predicted 159,000 or 168 % (95 % prediction interval (PI) 70-315) more deaths and 1,488,000 or 300 % (133-492) more hospitalizations. If a vaccine had been available after 100 days, over 71,000 deaths (16,507-204,249) and 384,000 (88,579-1,020,386) hospitalizations could have been averted. CONCLUSION Our results highlight the substantial impact of NPIs, including lockdowns and curfews, in controlling the COVID-19 pandemic. We also demonstrate the value of the 100 days objective of the Coalition for Epidemic Preparedness Innovations (CEPI) initiative for vaccine availability.
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Affiliation(s)
- Iris Ganser
- Univ. Bordeaux, Inserm, BPH Research Center, SISTM Team, UMR 1219 Bordeaux, France; McGill Health Informatics, School of Population and Global Health, McGill University, Montreal, Quebec, Canada
| | - David L Buckeridge
- McGill Health Informatics, School of Population and Global Health, McGill University, Montreal, Quebec, Canada
| | - Jane Heffernan
- Mathematics & Statistics, Centre for Disease Modelling, York University, Toronto, Ontario, Canada
| | - Mélanie Prague
- Univ. Bordeaux, Inserm, BPH Research Center, SISTM Team, UMR 1219 Bordeaux, France; Inria, Inria Bordeaux - Sud-Ouest, Talence, France; Vaccine Research Institute, F-94010 Creteil, France
| | - Rodolphe Thiébaut
- Univ. Bordeaux, Inserm, BPH Research Center, SISTM Team, UMR 1219 Bordeaux, France; Inria, Inria Bordeaux - Sud-Ouest, Talence, France; Vaccine Research Institute, F-94010 Creteil, France; Bordeaux University Hospital, Medical Information Department, Bordeaux, France.
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Beca-Martínez MT, Ayala A, Falcón-Romero M, Rodríguez-Blázquez C, Benito-Llanes A, Forjaz MJ, Romay-Barja M. Characteristics of adults who reported not having had COVID-19 in Spain after the first two years of the pandemic and associated factors. J Infect Public Health 2024; 17:435-442. [PMID: 38262081 DOI: 10.1016/j.jiph.2023.12.024] [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: 10/11/2023] [Revised: 12/22/2023] [Accepted: 12/31/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND There is little evidence regarding the characteristics of adults who self-reported not having had COVID-19 after two years of the pandemic. This study aimed to analyse the characteristics of no-COVID-19 respondents and the associated factors to better understand which may have conditioned not having had the disease as guidance to help in the design of better public health strategies. METHODS This cross-sectional, observational study was conducted in the Spanish general population in a representative sample of 1051 adults who completed an online survey in September 2022. Multivariable logistic regression was performed to assess which factors were related to reporting not having had COVID-19. RESULTS Almost half of the respondents (47.8%) reported not having ever had COVID-19. Significant differences were found between people who reported having had and not having had COVID-19 according to sex, age, education level, employment and living with children. No-COVID-19 respondents had greater concern and less fear of the disease and were more worried about the new variants. After the multivariable analysis, factors associated with no-COVID-19 respondents were male sex (OR)=1.40; 95% (CI=1.07-1.82), older age (OR=1.01; 95% CI=1.01-1.03), having a greater perception of disease severity if infected (OR=4.71; 95% CI=2.97-7.47), greater adherence to preventive measures (OR=1.02; 95% CI=1.01-1.03), and having received a complete vaccination schedule and booster dose (OR=1.56; 95% CI=1.03-2.36). CONCLUSIONS Analysing the characteristics of people reporting not having had COVID-19 can support public health decision-makers in designing better interventions and facilitating the implementation of effective prevention and control measures to prepare for and respond to a possible future pandemic.
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Affiliation(s)
- María Teresa Beca-Martínez
- Escuela Internacional de Doctorado de la Universidad Nacional de Educación a Distancia (UNED), Programa de Doctorado en Ciencias Biomédicas y Salud Pública, C/ Bravo Murillo, 38, 28015 Madrid, Spain
| | - Alba Ayala
- Unidad de Investigación en Cuidados y Servicios de Salud (Investén-ISCIII), Instituto de Salud Carlos III (ISCIII), Avda. Monforte de Lemos, 5, 28029 Madrid, Spain; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain
| | - María Falcón-Romero
- Departamento de Ciencias Sociales y de la Salud, Medicina Legal y Forense, Universidad de Murcia, Avda. Teniente Flomesta, 5, 30003 Murcia, Spain
| | - Carmen Rodríguez-Blázquez
- Centro Nacional de Epidemiología y Centro de Investigaciones Biomédicas en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III (ISCIII), Avda. Monforte de Lemos, 5, 28029 Madrid, Spain
| | - Agustín Benito-Llanes
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Avda. Monforte de Lemos 5, 28029 Madrid, Spain; Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III (ISCIII), Avda. Monforte de Lemos, 5, 28029 Madrid, Spain
| | - Maria João Forjaz
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain; Centro Nacional de Epidemiología, Instituto de Salud Carlos III (ISCIII), Avda. Monforte de Lemos, 5, 28029 Madrid, Spain
| | - María Romay-Barja
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Avda. Monforte de Lemos 5, 28029 Madrid, Spain; Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III (ISCIII), Avda. Monforte de Lemos, 5, 28029 Madrid, Spain.
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Barosa M, Jamrozik E, Prasad V. The Ethical Obligation for Research During Public Health Emergencies: Insights From the COVID-19 Pandemic. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2024; 27:49-70. [PMID: 38153559 PMCID: PMC10904511 DOI: 10.1007/s11019-023-10184-6] [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] [Accepted: 11/06/2023] [Indexed: 12/29/2023]
Abstract
In times of crises, public health leaders may claim that trials of public health interventions are unethical. One reason for this claim can be that equipoise-i.e. a situation of uncertainty and/or disagreement among experts about the evidence regarding an intervention-has been disturbed by a change of collective expert views. Some might claim that equipoise is disturbed if the majority of experts believe that emergency public health interventions are likely to be more beneficial than harmful. However, such beliefs are not always justified: where high quality research has not been conducted, there is often considerable residual uncertainty about whether interventions offer net benefits. In this essay we argue that high-quality research, namely by means of well-designed randomized trials, is ethically obligatory before, during, and after implementing policies in public health emergencies (PHEs). We contend that this standard applies to both pharmaceutical and non-pharmaceutical interventions, and we elaborate an account of equipoise that captures key features of debates in the recent pandemic. We build our case by analyzing research strategies employed during the COVID-19 pandemic regarding drugs, vaccines, and non-pharmaceutical interventions; and by providing responses to possible objections. Finally, we propose a public health policy reform: whenever a policy implemented during a PHE is not grounded in high-quality evidence that expected benefits outweigh harms, there should be a planned approach to generate high-quality evidence, with review of emerging data at preset time points. These preset timepoints guarantee that policymakers pause to review emerging evidence and consider ceasing ineffective or even harmful policies, thereby improving transparency and accountability, as well as permitting the redirection of resources to more effective or beneficial interventions.
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Affiliation(s)
- Mariana Barosa
- Nova Medical School, Nova University of Lisbon, Lisbon, Portugal
- Science and Technologies Studies (MSc student), University College London, London, UK
| | - Euzebiusz Jamrozik
- Ethox and Pandemic Sciences Institute, University of Oxford, Oxford, UK
- Royal Melbourne Hospital Department of Medicine, University of Melbourne, Melbourne, Australia
- Monash Bioethics Centre, Monash University, Melbourne, Australia
| | - Vinay Prasad
- University of California, San Francisco, 550 16th St, San Francisco, CA, 94158, USA.
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Kitaura S, Okamoto K. The effect of infectious diseases on lung transplantation in Japan. J Thorac Dis 2024; 16:1632-1644. [PMID: 38505071 PMCID: PMC10944739 DOI: 10.21037/jtd-22-1884] [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: 01/04/2023] [Accepted: 01/04/2024] [Indexed: 03/21/2024]
Abstract
Lung transplantation in Japan is an increasingly accessible treatment option for end-stage lung disease; however, the lack of donor organs is a persisting challenge. Five- and 10-year survival rates of lung transplant recipients in Japan are comparable, if not superior, to international standards. The outcomes of lung transplantation in Japan are likely affected by multiple factors. Infectious disease complications are a significant burden to transplant recipients and account for approximately 30% of recipient mortality in Japan, presenting a major challenge in peri-transplant management. Herein, we explore the current status of infectious disease epidemiology, available evidence surrounding infectious diseases in lung transplantation, and potentially influential factors pertinent to lung transplantation outcomes in Japan. Although infection remains the major cause of morbidity and mortality associated with lung transplantation in Japan, there is limited data and evidence. Despite some uncertainties, publicly available data suggests a low rate of antimicrobial resistance in Gram-negative bacteria and a distinct set of endemic pathogens that recipients may encounter. As a countermeasure against the burden of infectious diseases, 8 out of 10 transplant centers in Japan have a dedicated infectious diseases department. Despite these efforts, specific surveillance, prevention, and management are indispensable to improving post-transplantation infectious disease management. We accordingly lay out potential areas for improving infectious disease-related outcomes among lung transplant recipients in Japan.
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Affiliation(s)
- Satoshi Kitaura
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan
- Virology 1, National Institute of Infectious Diseases, Tokyo, Japan
| | - Koh Okamoto
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan
- Division of Infection Control and Prevention, Department of Infectious Diseases, Tokyo Medical and Dental University Hospital, Tokyo, Japan
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44
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Morand J, Yip S, Velegrakis Y, Lattanzi G, Potestio R, Tubiana L. Quality assessment and community detection methods for anonymized mobility data in the Italian Covid context. Sci Rep 2024; 14:4636. [PMID: 38409411 PMCID: PMC10897296 DOI: 10.1038/s41598-024-54878-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 02/17/2024] [Indexed: 02/28/2024] Open
Abstract
We discuss how to assess the reliability of partial, anonymized mobility data and compare two different methods to identify spatial communities based on movements: Greedy Modularity Clustering (GMC) and the novel Critical Variable Selection (CVS). These capture different aspects of mobility: direct population fluxes (GMC) and the probability for individuals to move between two nodes (CVS). As a test case, we consider movements of Italians before and during the SARS-Cov2 pandemic, using Facebook users' data and publicly available information from the Italian National Institute of Statistics (Istat) to construct daily mobility networks at the interprovincial level. Using the Perron-Frobenius (PF) theorem, we show how the mean stochastic network has a stationary population density state comparable with data from Istat, and how this ceases to be the case if even a moderate amount of pruning is applied to the network. We then identify the first two national lockdowns through temporal clustering of the mobility networks, define two representative graphs for the lockdown and non-lockdown conditions and perform optimal spatial community identification on both graphs using the GMC and CVS approaches. Despite the fundamental differences in the methods, the variation of information (VI) between them assesses that they return similar partitions of the Italian provincial networks in both situations. The information provided can be used to inform policy, for example, to define an optimal scale for lockdown measures. Our approach is general and can be applied to other countries or geographical scales.
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Affiliation(s)
- Jules Morand
- University of Trento, via Sommarive 14, 38123, Trento, Italy.
- INFN-TIFPA, Trento Institute for Fundamental Physics and Applications, 38123, Trento, Italy.
| | - Shoichi Yip
- University of Trento, via Sommarive 14, 38123, Trento, Italy
| | - Yannis Velegrakis
- University of Trento, via Sommarive 14, 38123, Trento, Italy
- Utrecht University, Princetonplein 5, 3584 CC, Utrecht, The Netherlands
| | - Gianluca Lattanzi
- University of Trento, via Sommarive 14, 38123, Trento, Italy
- INFN-TIFPA, Trento Institute for Fundamental Physics and Applications, 38123, Trento, Italy
| | - Raffaello Potestio
- University of Trento, via Sommarive 14, 38123, Trento, Italy
- INFN-TIFPA, Trento Institute for Fundamental Physics and Applications, 38123, Trento, Italy
| | - Luca Tubiana
- University of Trento, via Sommarive 14, 38123, Trento, Italy
- INFN-TIFPA, Trento Institute for Fundamental Physics and Applications, 38123, Trento, Italy
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45
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Sun L, Zhang Y, Chen Y, Chen L, Lei M. Validation of phenomenon and cross-sectional investigation of predictors for a post-COVID-19 surge of osteoporosis outpatients in China. Sci Rep 2024; 14:4230. [PMID: 38378764 PMCID: PMC10879099 DOI: 10.1038/s41598-024-54858-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 02/17/2024] [Indexed: 02/22/2024] Open
Abstract
An unexpected surge of osteoporosis outpatients occurred after COVID-19 lockdown was lifted in China. To confirm the observation and identify possible reasons driving patients care seeking behaviors post-pandemic, we compared the outpatient volumes at the osteoporosis clinic in January through May, 2019-2022 and surveyed seven osteoporosis specialists across China to validate the phenomenon before devising an online questionnaire to collect patients' characters and physical activity levels. Univariate and binary logistic regression analyses were calculated to identify predictors of post-lockdown care-seeking. We received 480 valid responses, including 397 (82.7%) patients having visited the clinic after lockdown and 83 (17.3%) having not. Four significant predictors were identified, including being female, experiencing pain, aggravating symptoms, and heightened anxiety during lockdown (P < 0.05). Both groups experienced lower physical activity levels during lockdown, which however was not a significant predictor (P = 0.317). The surge in osteoporosis outpatient visits after COVID-19 lockdown suggests vast latent demand for osteoporosis care accumulated during the pandemic. Four significant factors predict post-lockdown outpatient care-seeking, including being female, experiencing pain and aggravating symptoms, and heightened anxiety levels. Though physical activity levels decreased during lockdown, it failed to predict care-seeking. This demonstrates resilience of osteoporosis patients to resume regular care despite disruption and stress the substantial backlog of unmet healthcare needs.
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Affiliation(s)
- Lei Sun
- Department of Osteoporosis, Non-Communicable Diseases Research Center, West China-PUMC C.C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Yuehua Zhang
- Department of Osteoporosis, Non-Communicable Diseases Research Center, West China-PUMC C.C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Yao Chen
- Department of Osteoporosis, Non-Communicable Diseases Research Center, West China-PUMC C.C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Li Chen
- Department of Medical Records, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Mei Lei
- Department of Orthopaedics Medical Center, West China School of Public Health and West China Fourth Hospital, Sichuan University, #18 3Rd Section, Renmin Nan Road, Chengdu, 610041, Sichuan, People's Republic of China.
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46
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Overton CE, Abbey R, Baird T, Christie R, Daniel O, Day J, Gittins M, Jones O, Paton R, Tang M, Ward T, Wilkinson J, Woodrow-Hill C, Aldridge T, Chen Y. Identifying employee, workplace and population characteristics associated with COVID-19 outbreaks in the workplace: a population-based study. Occup Environ Med 2024; 81:92-100. [PMID: 38191477 DOI: 10.1136/oemed-2023-109032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 11/15/2023] [Indexed: 01/10/2024]
Abstract
OBJECTIVES To identify risk factors that contribute to outbreaks of COVID-19 in the workplace and quantify their effect on outbreak risk. METHODS We identified outbreaks of COVID-19 cases in the workplace and investigated the characteristics of the individuals, the workplaces, the areas they work and the mode of commute to work, through data linkages based on Middle Layer Super Output Areas in England between 20 June 2021 and 20 February 2022. We estimated population-level associations between potential risk factors and workplace outbreaks, adjusting for plausible confounders identified using a directed acyclic graph. RESULTS For most industries, increased physical proximity in the workplace was associated with increased risk of COVID-19 outbreaks, while increased vaccination was associated with reduced risk. Employee demographic risk factors varied across industry, but for the majority of industries, a higher proportion of black/African/Caribbean ethnicities and living in deprived areas, was associated with increased outbreak risk. A higher proportion of employees in the 60-64 age group was associated with reduced outbreak risk. There were significant associations between gender, work commute modes and staff contract type with outbreak risk, but these were highly variable across industries. CONCLUSIONS This study has used novel national data linkages to identify potential risk factors of workplace COVID-19 outbreaks, including possible protective effects of vaccination and increased physical distance at work. The same methodological approach can be applied to wider occupational and environmental health research.
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Affiliation(s)
- Christopher E Overton
- UK Health Security Agency, London, UK
- Department of Mathematical Sciences, University of Liverpool, Liverpool, UK
| | | | - Tarrion Baird
- UK Health Security Agency, London, UK
- Department of Pathology, University of Cambridge, Cambridge, UK
| | | | | | - Julie Day
- UK Health Security Agency, London, UK
| | - Matthew Gittins
- Centre for Biostatistics, The University of Manchester, Manchester, UK
| | | | | | | | - Tom Ward
- UK Health Security Agency, London, UK
| | - Jack Wilkinson
- Centre for Biostatistics, The University of Manchester, Manchester, UK
| | | | | | - Yiqun Chen
- Science Division, Health and Safety Executive, Buxton, UK
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Smith LE, West R, Potts HWW, Amlôt R, Fear NT, Rubin GJ, Michie S. Factors associated with wearing a facemask in shops in England following removal of a legal requirement to do so during the COVID-19 pandemic. Br J Health Psychol 2024; 29:3-19. [PMID: 37537895 DOI: 10.1111/bjhp.12684] [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: 01/13/2023] [Revised: 05/30/2023] [Accepted: 07/21/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVES We aimed to identify psychological factors associated with the use of facemasks in shops in England following removal of legal requirements to do so, and to compare associations with and without legal restrictions. DESIGN Repeated cross-sectional online surveys (n ≈ 2000 adults) between August 2020 and April 2022 (68,716 responses from 45,682 participants) using quota sampling. METHODS The outcome measure was whether those who had visited a shop for essentials in the previous seven days reported always having worn a facemask versus sometimes or not at all. Psychological predictor variables included worry, perceived risk and severity of COVID-19 and the perceived effectiveness of facemasks. Socio-demographic variables and measures of clinical vulnerability were also measured. For the period following removal of legal restrictions, multivariable regression was used to assess associations between the primary outcome variable and predictors adjusting for socio-demographic and clinical vulnerability measures. The analysis was repeated including interactions between psychological predictors and presence versus absence of legal restrictions. RESULTS Worry about COVID-19, beliefs about risks and severity of COVID-19 and effectiveness of facemasks were substantially and independently associated with the use of facemasks. Removal of legal obligations to wear facemasks was associated with a 25% decrease in wearing facemasks and stronger associations between psychological predictors and wearing facemasks. CONCLUSIONS Legal obligations increase rates of wearing a facemask. Psychological factors associated with wearing a facemask could be targets for interventions aiming to alter rates of wearing a facemask. These interventions may be more effective when there are no legal obligations to wear a face covering in place.
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Affiliation(s)
- Louise E Smith
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, London, UK
| | - Robert West
- Department of Behavioural Science and Health, University College London, London, UK
| | - Henry W W Potts
- Institute of Health Informatics, University College London, London, UK
| | - Richard Amlôt
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, London, UK
- Behavioural Science and Insights Unit, UK Health Security Agency, London, UK
| | - Nicola T Fear
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- King's Centre for Military Health Research and Academic Department of Military Mental Health, King's College London, London, UK
| | - G James Rubin
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, London, UK
| | - Susan Michie
- Centre for Behaviour Change, University College London, London, UK
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Gonzalez VM, Stewart TJ. COVID-19 vaccine hesitancy among American Indian and Alaska native college students: the roles of discrimination, historical trauma, and healthcare system distrust. J Behav Med 2024; 47:123-134. [PMID: 37634151 DOI: 10.1007/s10865-023-00443-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 08/09/2023] [Indexed: 08/29/2023]
Abstract
For American Indians and Alaska Native (AIAN) and other communities of color, experiences with discrimination and historical trauma may contribute to healthcare system distrust and negatively affect health care decisions, including vaccination. A saturated path analysis was conducted to examine the direct and indirect associations of thoughts regarding historical losses (of culture, language, and traditional ways) and AIAN racial discrimination with historical loss associated distress, healthcare system distrust, and COVID-19 vaccine hesitancy among AIAN college students (N = 391). Historical loss thoughts and experiences with racial discrimination were strongly associated with each other, and both were uniquely associated with greater historical loss associated distress. In turn, historical loss associated distress was associated with greater healthcare system distrust, which in turn was associated with greater likelihood of being COVID-19 vaccine hesitant. While further research is needed, the findings suggest that to address health disparities for AIAN people it is necessary to consider how to best overcome healthcare system distrust and factors that contribute to it, including historical trauma and contemporary experiences with discrimination.
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Affiliation(s)
- Vivian M Gonzalez
- Department of Psychology, University of Alaska Anchorage, 3211 Providence Drive, Anchorage, AK, 4464, 99508, USA.
| | - Tracy J Stewart
- Department of Psychology, University of Alaska Anchorage, 3211 Providence Drive, Anchorage, AK, 4464, 99508, USA
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Huang L, Yang C, Pan H, Gu Y, Li L, Kou M, Chen S, Wu J, Lian J, Zhang J, Gu J, Wei R, Chen H, Gong S, Zhang H, Xu Y, Lian Q. Effects of public health interventions and zero COVID policy on paediatric diseases: A Southern China study. J Glob Health 2024; 14:05011. [PMID: 38271211 PMCID: PMC10811438 DOI: 10.7189/jogh.14.05011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Abstract
Background With the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in schools and communities, clinical evidence is needed to determine the impact of the pandemic and public health interventions under the zero coronavirus disease policy on the occurrence of common infectious diseases and non-infectious diseases among children. Methods The current study was designed to analyse the occurrence of common infectious diseases before and after the pandemic outbreak in southern China. Data was obtained for 1 801 728 patients admitted into children's hospitals in Guangzhou between January 2017 and July 2022. Regression analysis was performed for data analysis. Results The annual occurrence of common paediatric infectious diseases remarkably decreased after the pandemic compared to the baseline before the pandemic and the monthly occurrence. Cases per month of common paediatric infectious diseases were significantly lower in five periods during the local outbreak when enhanced public health measures were in place. Cases of acute non-infectious diseases such as bone fractures were not reduced. Non-pharmaceutical interventions decreased annual and monthly cases of paediatric respiratory and intestinal infections during the coronavirus disease 2019 (COVID-19) pandemic, especially when enhanced public health interventions were in place. Conclusions Our findings provide clinical evidence that public health interventions under the dynamic zero COVID policy in the past three years had significant impacts on the occurrence of common respiratory and intestinal infectious diseases among children and adolescents but little impact on reducing non-infectious diseases such as leukaemia and bone fracture.
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Affiliation(s)
- Li Huang
- Prenatal Diagnostic Center and Cord Blood Bank, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Faculty of Synthetic Biology, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Department of Pharmacy, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Chen Yang
- Prenatal Diagnostic Center and Cord Blood Bank, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Faculty of Synthetic Biology, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Huoyun Pan
- Department of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Department of Infectious Diseases, Guangzhou Children's Hospital, Guangzhou, China
| | - Yiling Gu
- Department of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Department of Pediatrics, Guangzhou Maternal and Child Health Hospital, Guangzhou, China
| | - Ling Li
- Clinical Data Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Meng Kou
- Prenatal Diagnostic Center and Cord Blood Bank, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Shaoxiang Chen
- Prenatal Diagnostic Center and Cord Blood Bank, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Jianlong Wu
- Department of Pharmacy, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Jiacee Lian
- School of Health Sciences, Ngee Ann Polytechnic, Singapore
| | - Jinqiu Zhang
- Prenatal Diagnostic Center and Cord Blood Bank, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Jiaowei Gu
- Department of Pediatrics, Affiliated Taihe Hospital of Hubei University of Medicine, Shiyan, China
| | - Rui Wei
- Department of Gastroenterology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Hao Chen
- Department of Gastroenterology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Sitang Gong
- Department of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Hongwei Zhang
- Department of Navy Epidemiology, Faculty of Naval Medicine, Naval Medical University, Shanghai, China
| | - Yi Xu
- Department of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Department of Infectious Diseases, Guangzhou Children's Hospital, Guangzhou, China
| | - Qizhou Lian
- Prenatal Diagnostic Center and Cord Blood Bank, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Faculty of Synthetic Biology, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Department of Surgery, The University of Hong Kong Shenzhen Hospital, Shenzhen, China
- Department of Medicine and State Key Laboratory of Pharmaceutical Biotechnology, the University of Hong Kong, Special Administrative Region China
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Quinn GA, Connolly M, Fenton NE, Hatfill SJ, Hynds P, ÓhAiseadha C, Sikora K, Soon W, Connolly R. Influence of Seasonality and Public-Health Interventions on the COVID-19 Pandemic in Northern Europe. J Clin Med 2024; 13:334. [PMID: 38256468 PMCID: PMC10816378 DOI: 10.3390/jcm13020334] [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: 11/16/2023] [Revised: 12/22/2023] [Accepted: 01/03/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Most government efforts to control the COVID-19 pandemic revolved around non-pharmaceutical interventions (NPIs) and vaccination. However, many respiratory diseases show distinctive seasonal trends. In this manuscript, we examined the contribution of these three factors to the progression of the COVID-19 pandemic. METHODS Pearson correlation coefficients and time-lagged analysis were used to examine the relationship between NPIs, vaccinations and seasonality (using the average incidence of endemic human beta-coronaviruses in Sweden over a 10-year period as a proxy) and the progression of the COVID-19 pandemic as tracked by deaths; cases; hospitalisations; intensive care unit occupancy and testing positivity rates in six Northern European countries (population 99.12 million) using a population-based, observational, ecological study method. FINDINGS The waves of the pandemic correlated well with the seasonality of human beta-coronaviruses (HCoV-OC43 and HCoV-HKU1). In contrast, we could not find clear or consistent evidence that the stringency of NPIs or vaccination reduced the progression of the pandemic. However, these results are correlations and not causations. IMPLICATIONS We hypothesise that the apparent influence of NPIs and vaccines might instead be an effect of coronavirus seasonality. We suggest that policymakers consider these results when assessing policy options for future pandemics. LIMITATIONS The study is limited to six temperate Northern European countries with spatial and temporal variations in metrics used to track the progression of the COVID-19 pandemic. Caution should be exercised when extrapolating these findings.
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Affiliation(s)
- Gerry A. Quinn
- Centre for Molecular Biosciences, Ulster University, Coleraine BT52 1SA, UK
| | | | - Norman E. Fenton
- School of Electronic Engineering and Computer Science, Queen Mary University of London, London E1 4NS, UK
| | | | - Paul Hynds
- Spatiotemporal Environmental Epidemiology Research (STEER) Group, Environmental Sustainability & Health Institute, Technological University Dublin, D07 H6K8 Dublin, Ireland
- Irish Centre for Research in Applied Geoscience, University College Dublin, D04 F438 Dublin, Ireland
| | - Coilín ÓhAiseadha
- Spatiotemporal Environmental Epidemiology Research (STEER) Group, Environmental Sustainability & Health Institute, Technological University Dublin, D07 H6K8 Dublin, Ireland
- Department of Public Health, Health Service Executive, Dr Steevens’ Hospital, D08 W2A8 Dublin, Ireland
| | - Karol Sikora
- Department of Medicine, University of Buckingham Medical School, Buckingham MK18 1EG, UK
| | - Willie Soon
- Institute of Earth Physics and Space Science (ELKH EPSS), H-9400 Sopron, Hungary
- Center for Environmental Research and Earth Sciences (CERES), Salem, MA 01970, USA
| | - Ronan Connolly
- Independent Researcher, D08 Dublin, Ireland
- Center for Environmental Research and Earth Sciences (CERES), Salem, MA 01970, USA
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