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Martín-Sánchez M, Wu P, Adam DC, Yang B, Lim WW, Lin Y, Lau EH, Sullivan SG, Leung GM, Cowling BJ. An observational study on imported COVID-19 cases in Hong Kong during mandatory on-arrival hotel quarantine. PUBLIC HEALTH IN PRACTICE 2024; 8:100525. [PMID: 39050010 PMCID: PMC11267049 DOI: 10.1016/j.puhip.2024.100525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 05/23/2024] [Accepted: 06/05/2024] [Indexed: 07/27/2024] Open
Abstract
Background Hong Kong enforced stringent travel restrictions during the COVID-19 pandemic. Understanding the characteristics of imported COVID-19 cases is important for establishing evidence-based control measures. Methods Retrospective cohort study summarising the characteristics of imported cases detected in Hong Kong between 13 November 2020 and 31 January 2022, when compulsory quarantine was implemented. Findings A total of 2269 imported COVID-19 cases aged 0-85 years were identified, of which 48.6 % detected on arrival. A shorter median delay from arrival to isolation was observed in Delta and Omicron cases (3 days) than in ancestral strain and other variants cases (12 days; p < 0.001). Lower Ct values at isolation were observed in Omicron cases than in ancestral strain or other variants cases. No Omicron cases were detected beyond 14 days after arrival. Cases detected after 14 days of quarantine (n=58, 2.6 %) were more likely asymptomatic at isolation and had higher Ct value during isolation, some of them indicating re-positivity or post-arrival infections. Conclusions Testing inbound travellers at arrival and during quarantine can detect imported cases early, but may not prevent all COVID-19 introductions into the community. Public health measures should be adapted in response to the emergence of SARS-CoV-2 variants based on evidence from ongoing surveillance.
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Affiliation(s)
- Mario Martín-Sánchez
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Peng Wu
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health Limited (D4H), Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China
| | - Dillon C. Adam
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Bingyi Yang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Wey Wen Lim
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Yun Lin
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Eric H.Y. Lau
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health Limited (D4H), Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China
| | - Sheena G. Sullivan
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, and Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
- Department of Epidemiology, University of California, Los Angeles, USA
| | - Gabriel M. Leung
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health Limited (D4H), Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China
| | - Benjamin J. Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health Limited (D4H), Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China
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Lee K, Zhumatova S, Worsnop CZ, Bazak YL. Understanding the secondary outcomes of international travel measures during the covid-19 pandemic: a scoping review of social impact evidence. Global Health 2024; 20:59. [PMID: 39090727 PMCID: PMC11295557 DOI: 10.1186/s12992-024-01064-6] [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: 04/14/2024] [Accepted: 07/24/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Assessment of the effective use of international travel measures during the COVID-19 pandemic has focused on public health goals, namely limiting virus introduction and onward transmission. However, risk-based approaches includes the weighing of public health goals against potential social, economic and other secondary impacts. Advancing risk-based approaches thus requires fuller understanding of available evidence on such impacts. METHODS We conducted a scoping review of existing studies of the social impacts of international travel measures during the COVID-19 pandemic. Applying a standardized typology of travel measures, and five categories of social impact, we searched 9 databases across multiple disciplines spanning public health and the social sciences. We identified 26 studies for inclusion and reviewed their scope, methods, type of travel measure, and social impacts analysed. RESULTS The studies cover a diverse range of national settings with a strong focus on high-income countries. A broad range of populations are studied, hindered in their outbound or inbound travel. Most studies focus on 2020 when travel restrictions were widely introduced, but limited attention is given to the broader effects of their prolonged use. Studies primarily used qualitative or mixed methods, with adaptations to comply with public health measures. Most studies focused on travel restrictions, as one type of travel measure, often combined with domestic public health measures, making it difficult to determine their specific social impacts. All five categories of social impacts were observed although there was a strong emphasis on negative social impacts including family separation, decreased work opportunities, reduced quality of life, and inability to meet cultural needs. A small number of countries identified positive social impacts such as restored work-life balance and an increase in perceptions of safety and security. CONCLUSIONS While international travel measures were among the most controversial interventions applied during the COVID-19 pandemic, given their prolonged use and widespread impacts on individuals and populations, there remains limited study of their secondary impacts. If risk-based approaches are to be advanced, involving informed choices between public health and other policy goals, there is a need to better understand such impacts, including their differential impacts across diverse populations and settings.
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Affiliation(s)
- Kelley Lee
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
- Pandemics and Borders Project, Faculty of Health Sciences, Simon Fraser University, Blusson Hall 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
| | - Salta Zhumatova
- Pandemics and Borders Project, Faculty of Health Sciences, Simon Fraser University, Blusson Hall 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
| | - Catherine Z Worsnop
- School of Public Policy, University of Maryland, College Park, MD, 20742, USA
| | - Ying Liu Bazak
- Pandemics and Borders Project, Faculty of Health Sciences, Simon Fraser University, Blusson Hall 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
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Qiao H, Paansri P, Escobar LE. Global Mpox spread due to increased air travel. GEOSPATIAL HEALTH 2024; 19. [PMID: 38872388 DOI: 10.4081/gh.2024.1261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 03/04/2024] [Indexed: 06/15/2024]
Abstract
Mpox is an emerging, infectious disease that has caused outbreaks in at least 91 countries from May to August 2022. We assessed the link between international air travel patterns and Mpox transmission risk, and the relationship between the translocation of Mpox and human mobility dynamics after travel restrictions due to the COVID-19 pandemic had been lifted. Our three novel observations were that: i) more people traveled internationally after the removal of travel restrictions in the summer of 2022 compared to pre-pandemic levels; ii) countries with a high concentration of global air travel have the most recorded Mpox cases; and iii) Mpox transmission includes a number of previously nonendemic regions. These results suggest that international airports should be a primary location for monitoring the risk of emerging communicable diseases. Findings highlight the need for global collaboration concerning proactive measures emphasizing realtime surveillance.
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Affiliation(s)
- Huijie Qiao
- Institute of Zoology, Chinese Academy of Sciences, Beijing.
| | - Paanwaris Paansri
- Department of Fish and Wildlife Conservation, Virginia Tech, Blacksburg, VA.
| | - Luis E Escobar
- Department of Fish and Wildlife Conservation, Virginia Tech, Blacksburg, VA, United States; Global Change Center, Virginia Tech, Blacksburg, VA, United States; Center for Emerging Zoonotic and Arthropod-borne Pathogens, Virginia Tech, Blacksburg, VA, United States; Kellogg Center for Philosophy, Politics, and Economics, Virginia Tech, Blacksburg, VA.
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Crișan CA, Pop R, Stretea R, Milhem Z, Forray AI. Coping strategies, resilience and quality of life: reaction to the COVID-19 pandemic among Romanian physicians. HUMAN RESOURCES FOR HEALTH 2024; 22:28. [PMID: 38715124 PMCID: PMC11075254 DOI: 10.1186/s12960-024-00909-w] [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: 10/04/2023] [Accepted: 04/24/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND The COVID-19 pandemic has presented multiple psychological challenges for healthcare workers, such as anxiety, depression, burnout, and substance use disorders. In this research, we investigate the different ways Romanian physicians dealt with the difficult period of the COVID-19 pandemic. We also analyze how positive and negative stress-reducing strategies, as well as demographic variables, affect their psychological resilience and quality of life. Our goal is to provide a comprehensive overview of how physicians coped with the unprecedented global health challenges. METHODS We carried out a national cross-sectional study of 265 physicians in Romania between January 2021 and January 2022 using a web-based questionnaire. The study employed a web-based questionnaire to assess coping mechanisms using the COPE inventory, resilience through the Connor-Davidson Resilience Scale 25 (CD-RISC 25), and quality of life via the WHOQOL-BREF scale. The COPE inventory, consisting of 60 items across 15 subscales, categorizes coping strategies into problem-focused, emotion-focused, and dysfunctional types, with each item rated on a 4-point scale. The CD-RISC 25 measures resilience on a 5-point Likert scale, with total scores ranging from 0 to 100. WHOQOL-BREF assesses quality of life through 26 items in 4 domains: physical, mental, social relations, and environmental, scored from 1 to 5 and converted to a 0-100 scale for domain scores. Univariate and multivariate linear regression models were employed to discern the intricate relationships between coping strategies, resilience levels, quality of life dimensions, and pertinent demographic factors. RESULTS The average CD-RISC score among participants was 66.2. The mean scores for the values for the QOL subscales were 64.0 for physical well-being, 61.7 for psychological well-being, 61.2 for social relationships, and 64.7 for environment. Individuals tend to use problem-focused and emotion-focused coping more than dysfunctional mechanisms, according to the COPE inventory. Problem-focused and emotion-focused coping are positively correlated with resilience, while dysfunctional coping is negatively correlated. Resilience is significantly influenced by gender and professional status, with males and senior specialists reporting higher levels while younger physicians and residents reporting lower levels. CONCLUSIONS Our data points to specific protective characteristics and some detrimental factors on physicians' resilience and quality of life during the pandemic.
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Affiliation(s)
- Cătălina Angela Crișan
- Department of Neurosciences, Discipline of Psychiatry and Pediatric Psychiatry, Iuliu Hațieganu, University of Medicine and Pharmacy, 400349, Cluj-Napoca, Romania
| | - Răzvan Pop
- Clinical Hospital for Infectious Diseases, 400347, Cluj-Napoca, Romania.
| | - Roland Stretea
- Department of Neurosciences, Discipline of Psychiatry and Pediatric Psychiatry, Iuliu Hațieganu, University of Medicine and Pharmacy, 400349, Cluj-Napoca, Romania
| | - Zaki Milhem
- Department of Neurosciences, Discipline of Psychiatry and Pediatric Psychiatry, Iuliu Hațieganu, University of Medicine and Pharmacy, 400349, Cluj-Napoca, Romania
| | - Alina-Ioana Forray
- Department of Community Medicine, Discipline of Public Health and Management, Iuliu Hațieganu University of Medicine and Pharmacy, 400349, Cluj-Napoca, Romania
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Bazak YL, Sander B, Werker E, Zhumatova S, Worsnop CZ, Lee K. The economic impact of international travel measures used during the COVID-19 pandemic: a scoping review. BMJ Glob Health 2024; 9:e013900. [PMID: 38413100 PMCID: PMC10900439 DOI: 10.1136/bmjgh-2023-013900] [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: 09/07/2023] [Accepted: 02/11/2024] [Indexed: 02/29/2024] Open
Abstract
INTRODUCTION Assessment of the use of travel measures during COVID-19 has focused on their effectiveness in achieving public health objectives. However, the prolonged use of highly varied and frequently changing measures by governments, and their unintended consequences caused, has been controversial. This has led to a call for coordinated decision-making focused on risk-based approaches, which requires better understanding of the broader impacts of international travel measures (ITMs) on individuals and societies. METHODS Our scoping review investigates the literature on the economic impact of COVID-19 ITMs. We searched health, social science and COVID-19-specific databases for empirical studies preprinted or published between 1 January 2020 and 31 October 2023. Evidence was charted using a narrative approach and included jurisdiction of study, ITMs studied, study design, outcome categories, and main findings. RESULTS Twenty-six studies met the inclusion criteria and were included for data extraction. Twelve of them focused on the international travel restrictions implemented in early 2020. Limited attention was given to measures such as entry/exit screening and vaccination requirements. Eight studies focused on high-income countries, 6 on low-income and middle-income countries and 10 studies were comparative although did not select countries by income. Economic outcomes assessed included financial markets (n=13), economic growth (n=4), economic activities (n=1), performance of industries central to international travel (n=9), household-level economic status (n=3) and consumer behaviour (n=1). Empirical methods employed included linear regression (n=17), mathematical modelling (n=3) and mixed strategies (n=6). CONCLUSION Existing studies have begun to provide evidence of the wide-ranging economic impacts resulting from ITMs. However, the small body of research combined with difficulties in isolating the effects of such measures and limitations in available data mean that it is challenging to draw general and robust conclusions. Future research using rigorous empirical methods and high-quality data is needed on this topic.
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Affiliation(s)
- Ying Liu Bazak
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Beate Sander
- University Health Network, Toronto, Ontario, Canada
- University of Toronto Institute of Health Policy Management and Evaluation, Toronto, Ontario, Canada
| | - Eric Werker
- Simon Fraser University Beedie School of Business, Burnaby, British Columbia, Canada
| | - Salta Zhumatova
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | | | - Kelley Lee
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
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Banaski JA, Govender N, Groome MJ, Houser R, Greiner A, Krishnan S, Means B, Remmel R, Vélez Alvarado I, Standley CJ. Introducing www.epidemic-em.org: A Collection of Online Resources and Training Materials for Strengthening use of Emergency Operations Centers for Epidemic Response. Disaster Med Public Health Prep 2024; 18:e48. [PMID: 38389486 DOI: 10.1017/dmp.2024.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
OBJECTIVE This work aimed to demonstrate that a website, www.epidemic-em.org, encompassing "static" resources, and videos, as well as other tools, can be used to strengthen public health emergency management capacity during epidemic response. METHODS Existing resources were updated and developed for self-directed Emergency Operations Centers' capacity strengthening, in order to encompass current best practices, and to emphasize how public health emergency management concepts can support epidemic response activities. These materials formed the core of the website, launched in June 2020, to which country case studies were added. In 2021, a pilot virtual training program was designed using recorded video lectures and interviews with global experts in addition to the website material, which was delivered to South African responders. RESULTS The website has been accessed in more than 135 countries, demonstrating widespread reach and interest in online and freely accessible materials to support public health emergency operations. Over 30 people participated in the pilot virtual training, and the evaluation showed improvement in knowledge, confidence in using emergency management concepts for epidemic response, and positive feedback on the virtual modality. CONCLUSIONS Online tools can expand access to materials and resources for public health emergency management capacity strengthening. Virtual modalities can further serve as a powerful complement, and perhaps replacement, for traditional in-person technical assistance, despite some limitations.
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Affiliation(s)
- James A Banaski
- Center for Global Health Science and Security, Georgetown University, WashingtonDC, USA
- Emergency Management Training & Consulting LLC, AtlantaGA, USA
| | - Nevashan Govender
- National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
| | - Michelle J Groome
- National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ryan Houser
- Center for Global Health Science and Security, Georgetown University, WashingtonDC, USA
- School of Continuing Studies, Georgetown University, WashingtonDC, USA
| | - Ashley Greiner
- Division of Global Health Protection, US Centers for Disease Control and Prevention, AtlantaGA, USA
| | - Sharanya Krishnan
- Division of Emergency Operations, U.S. Centers for Disease Control and Prevention, AtlantaGA, USA
| | - Brenna Means
- Center for Global Health Science and Security, Georgetown University, WashingtonDC, USA
- School of Continuing Studies, Georgetown University, WashingtonDC, USA
| | - Ryan Remmel
- Center for Global Health Science and Security, Georgetown University, WashingtonDC, USA
- Walsh School of Foreign Service, Georgetown University, WashingtonDC, USA
| | - Ileana Vélez Alvarado
- Center for Global Health Science and Security, Georgetown University, WashingtonDC, USA
- School of Continuing Studies, Georgetown University, WashingtonDC, USA
| | - Claire J Standley
- Center for Global Health Science and Security, Georgetown University, WashingtonDC, USA
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
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Ambalavanan R, Snead RS, Marczika J, Malioukis A. Epidemiological contemplation for a currently pragmatic COVID-19 health passport: a perspective. Front Public Health 2024; 12:1347623. [PMID: 38414904 PMCID: PMC10896918 DOI: 10.3389/fpubh.2024.1347623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 01/23/2024] [Indexed: 02/29/2024] Open
Abstract
The coronavirus disease 2019 (COVID-19) has caused a global pandemic that has wreaked havoc on the lives of millions of people around the world. Confinement measures aim to reduce the epidemic's spread and minimize the burden of morbidity and mortality. In response to the challenges caused by the pandemic, digital health passports have been developed exponentially. We highlight the latent epidemiological barriers to health passports to achieve standardized digital care platforms. This review paper not only highlights the epidemiological barriers but also articulates the possible infrastructure required to make the International Standard for a multi-factor authenticated and validated health passport.
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Affiliation(s)
- Radha Ambalavanan
- Research Department, The Self Research Institute, Broken Arrow, OK, United States
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Waite LL, Nahhas A, Irvahn J, Garden G, Kerfonta CM, Killelea E, Ferng W, Cummins JJ, Mereness R, Austin T, Jones S, Olson N, Wilson M, Isaac B, Pepper CA, Koolhof IS, Armstrong J. COVID-19 passenger screening to reduce travel risk and translocation of disease. Epidemiol Infect 2024; 152:e36. [PMID: 38326275 PMCID: PMC10945944 DOI: 10.1017/s0950268824000220] [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: 08/29/2023] [Revised: 01/11/2024] [Accepted: 01/24/2024] [Indexed: 02/09/2024] Open
Abstract
Aviation passenger screening has been used worldwide to mitigate the translocation risk of SARS-CoV-2. We present a model that evaluates factors in screening strategies used in air travel and assess their relative sensitivity and importance in identifying infectious passengers. We use adapted Monte Carlo simulations to produce hypothetical disease timelines for the Omicron variant of SARS-CoV-2 for travelling passengers. Screening strategy factors assessed include having one or two RT-PCR and/or antigen tests prior to departure and/or post-arrival, and quarantine length and compliance upon arrival. One or more post-arrival tests and high quarantine compliance were the most important factors in reducing pathogen translocation. Screening that combines quarantine and post-arrival testing can shorten the length of quarantine for travelers, and variability and mean testing sensitivity in post-arrival RT-PCR and antigen tests decrease and increase with the greater time between the first and second post-arrival test, respectively. This study provides insight into the role various screening strategy factors have in preventing the translocation of infectious diseases and a flexible framework adaptable to other existing or emerging diseases. Such findings may help in public health policy and decision-making in present and future evidence-based practices for passenger screening and pandemic preparedness.
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Affiliation(s)
| | - Ahmad Nahhas
- The Boeing Company, Arlington, Virginia, United States
| | - Jan Irvahn
- The Boeing Company, Arlington, Virginia, United States
| | - Grace Garden
- The Boeing Company, Arlington, Virginia, United States
| | | | | | - William Ferng
- The Boeing Company, Arlington, Virginia, United States
| | | | | | - Thomas Austin
- The Boeing Company, Arlington, Virginia, United States
| | - Stephen Jones
- The Boeing Company, Arlington, Virginia, United States
| | - Nels Olson
- The Boeing Company, Arlington, Virginia, United States
| | - Mark Wilson
- The Boeing Company, Arlington, Virginia, United States
| | - Benson Isaac
- The Boeing Company, Arlington, Virginia, United States
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Howkins J, Packer S, Walsh E, Kumar D, Edeghere O, Hickman M, Oliver I. Risk of transmission of SARS-CoV-2 on international flights, a retrospective cohort study using national surveillance data in England. BMC Infect Dis 2024; 24:174. [PMID: 38326781 PMCID: PMC10851503 DOI: 10.1186/s12879-024-09052-2] [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: 10/24/2023] [Accepted: 01/24/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND It is not yet fully understood to what extent in-flight transmission contributed to the spread of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). This study aimed to determine the occurrence and extent of SARS-CoV-2 transmission in-flight and assess factors associated with transmission risk to inform future control strategies. METHODS Retrospective cohort study using data obtained from contact tracing of international flights arriving in England between 02/08/2021-15/10/2021. Transmission risk was estimated by calculating the secondary attack rate (SAR). Univariable and multivariable analyses of the SAR by specific risk factors was undertaken, including: number of in-flight index cases; number of symptomatic index cases; contact vaccination status; flight duration; proximity to the index case(s); contact age. RESULTS 11,307 index cases linked to 667,849 contacts with 5,289 secondary cases reported. In-flight SAR was 0.79% (95% CI: 0.77-0.81). Increasing numbers of symptomatic cases (when > 4 index cases compared to one index case aOR 1.85; 95% CI: 1.40-2.44) and seating proximity to an index case (seated within compared to outside of two rows OR 1.82; 95% CI: 1.50-2.22) were associated with increased risk of secondary cases. Full vaccination history was protective (aOR 0.52; 95% CI: 0.47-0.57). CONCLUSIONS This study confirms that in-flight transmission of SARS-CoV-2 occurred. There are factors associated with increased risk of infection. Contact tracing identified exposed persons who subsequently developed infection. A targeted approach to contact tracing passengers with the highest exposure risk could be an effective use of limited public health resources.
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Affiliation(s)
- Joshua Howkins
- UK Health Security Agency, 5th Floor, 10 South Colonnade, E14 4PU, London, UK.
| | - Simon Packer
- Health Protection Operations, UK Health Security Agency, 5th Floor, 10 South Colonnade, E14 4PU, London, UK
| | | | - Deepti Kumar
- UK Health Security Agency, 61 Colindale Avenue, NW9 5EQ, London, UK
| | - Obaghe Edeghere
- UK Health Security Agency, 61 Colindale Avenue, NW9 5EQ, London, UK
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Isabel Oliver
- UK Health Security Agency, 5th Floor, 10 South Colonnade, E14 4PU, London, UK
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Orji B, Bryce E, Odio B, Onuoha H, Njoku E, Anoke C, Ugwa E, Enne J, Oniyire A, Ibrahim I, Otolorin E, Afolabi K, Ogbulafor NC, Oliveras E. The COVID-19 Pandemic's Impact on Health Service Utilization Among Pregnant Women in Three Nigerian States: A Mixed Methods Study. Matern Child Health J 2024; 28:294-302. [PMID: 37975998 PMCID: PMC10901963 DOI: 10.1007/s10995-023-03820-3] [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] [Accepted: 10/23/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE COVID-19 disrupted health service delivery and weakened global and national health systems. The objective of this study was to describe the changes in health service utilization in three local government areas (LGAs) in Nigeria and examine factors involved. METHODS A cross-sectional mixed-methods approach was used. A total of 315 pregnant women seen for antenatal care in 80 health facilities in three LGAs between October 1 and November 30, 2020, participated in exit interviews; 93 women participated in focus group discussions (FGDs). Descriptive analyses and a multivariable logistic analysis were conducted to examine associations between characteristics and decreased service utilization. Content analysis was used to identify the emerging themes related to health service utilization during the pandemic. RESULTS One quarter of women reported that they reduced or ceased health service. The biggest reported changes were in immunization (47 to 30%, p < 0.001) and a small but statistically significant decline in antenatal care (98.7 to 93.8%, p < 0.001) was observed. Qualitative findings show that lockdowns, transportation issues, increased costs and fear of contracting COVID-19 or being labeled as COVID-positive were the most common reasons for not seeking care during this period of the pandemic. CONCLUSIONS The pandemic negatively impacted health service utilization amongst pregnant women in Nigeria. A better understanding of differences in state response could help inform future actions. The findings highlight the need for health systems to consider how to facilitate service utilization during a pandemic, such as providing safe transport or increasing outreach, and to minimize stigma for those seeking care.
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Affiliation(s)
- Bright Orji
- Jhpiego-an Affiliate of Johns Hopkins University, Abuja, Nigeria.
| | - Emily Bryce
- Jhpiego-an Affiliate of Johns Hopkins University, Baltimore, MD, USA
| | - Bartholomew Odio
- Jhpiego-an Affiliate of Johns Hopkins University, Abuja, Nigeria
| | - Herbert Onuoha
- Jhpiego-an Affiliate of Johns Hopkins University, Abuja, Nigeria
| | - Elizabeth Njoku
- Jhpiego-an Affiliate of Johns Hopkins University, Abuja, Nigeria
| | - Charity Anoke
- Jhpiego-an Affiliate of Johns Hopkins University, Abuja, Nigeria
| | | | - Joseph Enne
- Jhpiego-an Affiliate of Johns Hopkins University, Abuja, Nigeria
| | | | | | - Emmanuel Otolorin
- Jhpiego-an Affiliate of Johns Hopkins University, Baltimore, MD, USA
| | - Kayode Afolabi
- Reproductive Health Division, Federal Ministry of Health, Abuja, Nigeria
| | - Nnenna C Ogbulafor
- National Malaria Elimination Program, Federal Ministry of Health, Abuja, Nigeria
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11
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ADOM ATÈHÈZI, AFANVI KOSSIVIAGBÉLÉNKO, SADIO ARNOLDJUNIOR, ADOLI LATAMEKOMLA, TOGAN ROMÉOMEDESSÈ, TCHANKONI MARTINKOUAME, KONU YAORODION, GBEASOR-KOMLANVI FIFONSIADJIDOSSI, GNARO TAKPAYA, ADOM PANAVEYIMALOU, EKOUEVI DIDIERKOUMAVI. COVID-19 vaccination coverage among travellers at Lomé international airport (Togo), in 2022. J Public Health Afr 2023; 14:2597. [PMID: 38269107 PMCID: PMC10807365 DOI: 10.4081/jphia.2024.2597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024] Open
Abstract
COVID-19 pandemic management leads to new health policies including the requirement of a vaccination pass or a negative Polymerase Chain Reaction (PCR) test for cross-border flights. The objective of this study was to estimate COVID-19 vaccination coverage among travellers, as well as factors associated with a full vaccination. A cross sectional study was conducted in July 2022 at the Gnassingbé Eyadema International Airport (LFW) in Lomé. Travellers met at LFW, aged 12 years or above, and who agreed to participate in the study have been submitted a questionnaire. Logistic regression analysis was performed to identify factors associated with full vaccination defined as having received at least two doses of COVID-19 vaccine according to a validated vaccine schedule. A total of 847 travellers were included. 67% were men The median age was 40 years, Interquartile Range [31-48]. The main health document presented by travellers was the vaccination pass (69.1%). The majority (84.4%) of travellers had received at least one dose of COVID-19 vaccine and 63.9% had received at least two doses. Being 40 years of age or above (aOR=1.42; P=0.046), and travelling from a country outside Africa (aOR=2.18, P=0.003), were positively associated with full vaccination. Vaccination coverage among travellers at the LFW was relatively high. Travellers from a region outside Africa and aged 40 years or above were more likely to be full vaccinated. Better communication and strengthening of the vaccination strategies in Africa could help reduce these gaps.
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Affiliation(s)
- ATÈHÈZI ADOM
- University of Lomé, Training and Research Centre in Public Health
| | | | | | - LATAME KOMLA ADOLI
- University of Lomé, Faculty of Health Sciences, Department of Public Health
| | - ROMÉO MEDESSÈ TOGAN
- University of Lomé, Faculty of Health Sciences, Department of Public Health
- African Research Center for Epidemiology and Public Health, Lomé, Togo
| | - MARTIN KOUAME TCHANKONI
- University of Lomé, Faculty of Health Sciences, Department of Public Health
- African Research Center for Epidemiology and Public Health, Lomé, Togo
| | | | | | - TAKPAYA GNARO
- University of Lomé, Training and Research Centre in Public Health
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Anzai A, Yamasaki S, Bleichrodt A, Chowell G, Nishida A, Nishiura H. Epidemiological impact of travel enhancement on the inter-prefectural importation dynamics of COVID-19 in Japan, 2020. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2023; 20:21499-21513. [PMID: 38124607 DOI: 10.3934/mbe.2023951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Mobility restrictions were widely practiced to reduce contact with others and prevent the spatial spread of COVID-19 infection. Using inter-prefectural mobility and epidemiological data, a statistical model was devised to predict the number of imported cases in each Japanese prefecture. The number of imported cases crossing prefectural borders in 2020 was predicted using inter-prefectural mobility rates based on mobile phone data and prevalence estimates in the origin prefectures. The simplistic model was quantified using surveillance data of cases with an inter-prefectural travel history. Subsequently, simulations were carried out to understand how imported cases vary with the mobility rate and prevalence at the origin. Overall, the predicted number of imported cases qualitatively captured the observed number of imported cases over time. Although Hokkaido and Okinawa are the northernmost and the southernmost prefectures, respectively, they were sensitive to differing prevalence rate in Tokyo and Osaka and the mobility rate. Additionally, other prefectures were sensitive to mobility change, assuming that an increment in the mobility rate was seen in all prefectures. Our findings indicate the need to account for the weight of an inter-prefectural mobility network when implementing countermeasures to restrict human movement. If the mobility rates were maintained lower than the observed rates, then the number of imported cases could have been maintained at substantially lower levels than the observed, thus potentially preventing the unnecessary spatial spread of COVID-19 in late 2020.
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Affiliation(s)
- Asami Anzai
- Graduate School of Medicine, Kyoto University, Yoshidakonoecho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Syudo Yamasaki
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo, Japan
| | - Amanda Bleichrodt
- School of Public Health, Georgia State University, 140 Decatur St., Atlanta, GA 30303, USA
| | - Gerardo Chowell
- School of Public Health, Georgia State University, 140 Decatur St., Atlanta, GA 30303, USA
| | - Atsushi Nishida
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo, Japan
- Tokyo Center for Infectious Disease Control and Prevention, Shinjuku-ku, Tokyo, Japan
| | - Hiroshi Nishiura
- Graduate School of Medicine, Kyoto University, Yoshidakonoecho, Sakyo-ku, Kyoto 606-8501, Japan
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Moreira-Soto A, Bruno A, de Mora D, Paez M, Garces J, Wulf B, Sander AL, Olmedo M, Basantes Mantilla MJ, Gonzalez Gonzalez M, Orlando SA, Salgado Cisneros S, Zevallos JC, Drexler JF. Virological evidence of the impact of non-pharmaceutical interventions against COVID-19 in Ecuador, a resource-limited setting. Emerg Microbes Infect 2023; 12:2259001. [PMID: 37698611 PMCID: PMC10563623 DOI: 10.1080/22221751.2023.2259001] [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: 05/14/2023] [Accepted: 09/10/2023] [Indexed: 09/13/2023]
Abstract
Ecuador had substantial COVID-19-mortality during 2020 despite early implementation of non-pharmaceutical interventions (NPIs). Resource-limited settings like Ecuador have high proportions of informal labour which entail high human mobility, questioning efficacy of NPIs. We performed a retrospective observational study in Ecuador's national reference laboratory for viral respiratory infections during March 2020-February 2021 using stored respiratory specimens from 1950 patients, corresponding to 2.3% of all samples analysed within the Ecuadorian national surveillance system per week. During 2020, detection of SARS-CoV-2 (Pearson correlation; r = -0.74; p = 0.01) and other respiratory viruses (Pearson correlation; r = -0.68; p = 0.02) by real-time RT-PCR correlated negatively with NPIs stringency. Among respiratory viruses, adenoviruses (Fisher's exact-test; p = 0.026), parainfluenzaviruses (p = 0.04), enteroviruses (p < 0.0001) and metapneumoviruses (p < 0.0001) occurred significantly more frequently during months of absent or non-stringent NPIs (characterized by <55% stringency according to the Oxford stringency index data for Ecuador). Phylogenomic analyses of 632 newly characterized SARS-CoV-2 genomes revealed 100 near-parallel SARS-CoV-2 introductions during early 2020 in the absence of NPIs. NPI stringency correlated negatively with the number of circulating SARS-CoV-2 lineages during 2020 (r = -0.69; p = 0.02). Phylogeographic reconstructions showed differential SARS-CoV-2 dispersion patterns during 2020, with more short-distance transitions potentially associated with recreational activity during non-stringent NPIs. There were also fewer geographic transitions during strict NPIs (n = 450) than during non-stringent or absent NPIs (n = 580). Virological evidence supports that NPIs had an effect on virus spread and distribution in Ecuador, providing a template for future epidemics in resource-limited settings and contributing to a balanced assessment of societal costs entailed by strict NPIs.
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Affiliation(s)
- Andres Moreira-Soto
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin, Institute of Virology, Berlin, Germany
- Tropical Disease Research Program, School of Veterinary Medicine, Universidad Nacional, Costa Rica, Costa Rica
| | - Alfredo Bruno
- National Institute of Public Health Research (INSPI), Guayaquil, Ecuador
- Universidad Agraria del Ecuador, Guayaquil, Ecuador
| | - Doménica de Mora
- National Institute of Public Health Research (INSPI), Guayaquil, Ecuador
| | - Michelle Paez
- National Institute of Public Health Research (INSPI), Guayaquil, Ecuador
| | - Jimmy Garces
- National Institute of Public Health Research (INSPI), Guayaquil, Ecuador
| | - Ben Wulf
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin, Institute of Virology, Berlin, Germany
| | - Anna-Lena Sander
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin, Institute of Virology, Berlin, Germany
| | - Maritza Olmedo
- National Institute of Public Health Research (INSPI), Guayaquil, Ecuador
| | | | - Manuel Gonzalez Gonzalez
- National Institute of Public Health Research (INSPI), Guayaquil, Ecuador
- Universidad ECOTEC, Km 13.5 Samborondon, Samborondon, EC092302, Ecuador
| | - Solon Alberto Orlando
- National Institute of Public Health Research (INSPI), Guayaquil, Ecuador
- Health Science Faculty, Universidad Espíritu Santo, Guayaquil, Ecuador
| | | | - Juan Carlos Zevallos
- Health Science Faculty, Universidad Espíritu Santo, Guayaquil, Ecuador
- Alianza para la Investigación de Enfermedades Emergentes (AIE), Quito, Ecuador
| | - Jan Felix Drexler
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin, Institute of Virology, Berlin, Germany
- German Centre for Infection Research (DZIF), Associated Partner Site Charité, Berlin, Germany
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Grépin KA, Aston J, Burns J. Effectiveness of international border control measures during the COVID-19 pandemic: a narrative synthesis of published systematic reviews. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2023; 381:20230134. [PMID: 37611627 PMCID: PMC10446907 DOI: 10.1098/rsta.2023.0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 05/23/2023] [Indexed: 08/25/2023]
Abstract
The effectiveness of international border control measures during the COVID-19 pandemic is not well understood. Using a narrative synthesis approach to published systematic reviews, we synthesized the evidence from both modelling and observational studies on the effects of border control measures on domestic transmission of the virus. We find that symptomatic screening measures were not particularly effective, but that diagnostic-based screening methods were more effective at identifying infected travellers. Targeted travel restrictions levied against travellers from Wuhan were likely temporarily effective but insufficient to stop the exportation of the virus to the rest of the world. Quarantine of inbound travellers was also likely effective at reducing transmission, but only with relatively long quarantine periods, and came with important economic and social effects. There is little evidence that most travel restrictions, including border closure and those implemented to stop the introduction of new variants of concern, were particularly effective. Border control measures played an important role in former elimination locations but only when coupled with strong domestic public health measures. In future outbreaks, if border control measures are to be adopted, they should be seen as part of a broader strategy that includes other non-pharmaceutical interventions. This article is part of the theme issue 'The effectiveness of non-pharmaceutical interventions on the COVID-19 pandemic: the evidence'.
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Affiliation(s)
- Karen Ann Grépin
- School of Public Health, University of Hong Kong Faculty of Medicine, Pokfulam, Hong Kong
| | - John Aston
- Statistical Laboratory, University of Cambridge, Cambridge, CB3 0WB, UK
| | - Jacob Burns
- Ludwig-Maximilians University, Munich, 81377, Germany
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Francis JR, de Araujo RM, da Silva Viegas O, Lobo S, Coelho D, Mathur A, Bothra V, Yu D, Draper ADK, Yan J, Martins N. The response to COVID-19 in Timor-Leste: lessons learnt. BMJ Glob Health 2023; 8:e013573. [PMID: 37821115 PMCID: PMC10583031 DOI: 10.1136/bmjgh-2023-013573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/11/2023] [Indexed: 10/13/2023] Open
Abstract
The response to the COVID-19 pandemic in Timor-Leste offers lessons that may be useful for incorporating into future responses to infectious disease outbreaks in similar resource-limited settings. In this paper, we identify nine key areas for learning from Timor-Leste's experience of the COVID-19 pandemic: (1) the importance of prior preparation for health emergencies, (2) the establishment of effective leadership and governance structures, (3) the protective impact of early border restrictions, (4) the rapid expansion of diagnostic laboratory capacity, (5) the impact of effective health communications in supporting the vaccine roll-out, (6) the opportunity to build capacity for clinical care, (7) the use of public health interventions that were found to have limited public health impact, (8) the broader effects of the pandemic and the public health response and (9) translation of lessons from COVID-19 to other public health priorities.
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Affiliation(s)
- Joshua R Francis
- Centro Integrado de Gestao de Crises, Dili, Timor-Leste
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
| | | | - Odete da Silva Viegas
- Centro Integrado de Gestao de Crises, Dili, Timor-Leste
- Ministerio da Saude, Dili, Timor-Leste
| | - Sergio Lobo
- Centro Integrado de Gestao de Crises, Dili, Timor-Leste
| | - Danina Coelho
- Centro Integrado de Gestao de Crises, Dili, Timor-Leste
| | - Arvind Mathur
- Centro Integrado de Gestao de Crises, Dili, Timor-Leste
- World Health Organization, Dili, Timor-Leste
| | - Vinay Bothra
- Centro Integrado de Gestao de Crises, Dili, Timor-Leste
- World Health Organization, Dili, Timor-Leste
| | - Dongbao Yu
- Centro Integrado de Gestao de Crises, Dili, Timor-Leste
- World Health Organization, Dili, Timor-Leste
| | - Anthony D K Draper
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
- National Centre for Epidemiology and Population Health, Canberra, Australian Capital Territory, Australia
| | - Jennifer Yan
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
| | - Nelson Martins
- Centro Integrado de Gestao de Crises, Dili, Timor-Leste
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
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16
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Paulo MS, Peyroteo M, Maia MR, Pries C, Habl C, Lapão LV. Impacts of public health and social measures on COVID-19 in Europe: a review and modified Delphi technique. Front Public Health 2023; 11:1226922. [PMID: 37719729 PMCID: PMC10501783 DOI: 10.3389/fpubh.2023.1226922] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 08/22/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction The emergence of the COVID-19 pandemic in early 2020 led countries to implement a set of public health and social measures (PHSMs) attempting to contain the spread of the SARS-CoV-2 virus. This study aims to review the existing literature regarding key results of the PHSMs that were implemented, and to identify the PHSMs considered to have most impacted the epidemiological curve of COVID-19 over the last years during different stages of the pandemic. Methods The PHSM under study were selected from the Oxford COVID-19 Government Response Tracker (OxCGRT), supplemented by topics presented during the Rapid Exchange Forum (REF) meetings in the scope of the Population Health Information Research Infrastructure (PHIRI) project (H2020). The evidence- based review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to identify which reviews have already been published about each PHSMs and their results. In addition, two modified Delphi panel surveys were conducted among subject matter experts from 30 European countries to uphold the results found. Results There were 3,212 studies retrieved from PubMed, 162 full texts assessed for eligibility and 35 included in this PHSMs summary. The measures with clearest evidence on their positive impact from the evidence-based review include social distancing, hygiene measures, mask measures and testing policies. From the modified Delphi panel, the PHSMs considered most significant in the four periods analyzed were case isolation at home, face coverings, testing policy, and social distancing, respectively. Discussion The evidence found has significant implications for both researchers and policymakers. The study of PHSMs' impact on COVID-19 illustrates lessons learned for future pan- and epidemics, serving as a contribution to the health systems resilience discussion. These lessons, drawn from both the available scientific evidence and the perspectives of relevant subject matter experts, should also be considered in educational and preparedness programs and activities in the public health space.
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Affiliation(s)
- Marília Silva Paulo
- CHRC, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Mariana Peyroteo
- CHRC, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
- UNIDEMI, Department of Mechanical and Industrial Engineering, NOVA School of Science and Technology, Universidade NOVA de Lisboa, Caparica, Portugal
- LASI, Laboratório Associado de Sistemas Inteligentes, Guimarães, Portugal
| | - Mélanie R. Maia
- UNIDEMI, Department of Mechanical and Industrial Engineering, NOVA School of Science and Technology, Universidade NOVA de Lisboa, Caparica, Portugal
- LASI, Laboratório Associado de Sistemas Inteligentes, Guimarães, Portugal
| | - Cara Pries
- Gesundheit Österreich GmbH (Austrian National Public Health Institute), Vienna, Austria
| | - Claudia Habl
- Gesundheit Österreich GmbH (Austrian National Public Health Institute), Vienna, Austria
| | - Luís Velez Lapão
- CHRC, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
- UNIDEMI, Department of Mechanical and Industrial Engineering, NOVA School of Science and Technology, Universidade NOVA de Lisboa, Caparica, Portugal
- LASI, Laboratório Associado de Sistemas Inteligentes, Guimarães, Portugal
- WHO Collaborating Center for Health Workforce Policy and Planning, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisbon, Portugal
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17
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Yang L, Hu M, Zeng H, Liang W, Zhu J. The impact of multiple non-pharmaceutical interventions for China-bound travel on domestic COVID-19 outbreaks. Front Public Health 2023; 11:1202996. [PMID: 37521963 PMCID: PMC10373927 DOI: 10.3389/fpubh.2023.1202996] [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: 04/10/2023] [Accepted: 06/01/2023] [Indexed: 08/01/2023] Open
Abstract
Objectives Non-pharmaceutical interventions (NPIs) implemented on China-bound travel have successfully mitigated cross-regional transmission of COVID-19 but made the country face ripple effects. Thus, adjusting these interventions to reduce interruptions to individuals' daily life while minimizing transmission risk was urgent. Methods An improved Susceptible-Infected-Recovered (SIR) model was built to evaluate the Delta variant's epidemiological characteristics and the impact of NPIs. To explore the risk associated with inbound travelers and the occurrence of domestic traceable outbreaks, we developed an association parameter that combined inbound traveler counts with a time-varying initial value. In addition, multiple time-varying functions were used to model changes in the implementation of NPIs. Related parameters of functions were run by the MCSS method with 1,000 iterations to derive the probability distribution. Initial values, estimated parameters, and corresponding 95% CI were obtained. Reported existing symptomatic, suspected, and asymptomatic case counts were used as the training datasets. Reported cumulative recovered individual data were used to verify the reliability of relevant parameters. Lastly, we used the value of the ratio (Bias2/Variance) to verify the stability of the mathematical model, and the effects of the NPIs on the infected cases to analyze the sensitivity of input parameters. Results The quantitative findings indicated that this improved model was highly compatible with publicly reported data collected from July 21 to August 30, 2021. The number of inbound travelers was associated with the occurrence of domestic outbreaks. A proportional relationship between the Delta variant incubation period and PCR test validity period was found. The model also predicted that restoration of pre-pandemic travel schedules while adhering to NPIs requirements would cause shortages in health resources. The maximum demand for hospital beds would reach 25,000/day, the volume of PCR tests would be 8,000/day, and the number of isolation rooms would reach 800,000/day within 30 days. Conclusion With the pandemic approaching the end, reexamining it carefully helps better address future outbreaks. This predictive model has provided scientific evidence for NPIs' effectiveness and quantifiable evidence of health resource allocation. It could guide the design of future epidemic prevention and control policies, and provide strategic recommendations on scarce health resource allocation.
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Affiliation(s)
- Lichao Yang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Mengzhi Hu
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Huatang Zeng
- Shenzhen Health Development Research and Data Management Center, Shenzhen, Guangdong, China
| | - Wannian Liang
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Jiming Zhu
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
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18
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Worsnop CZ, Nass S, Grépin KA, Lee K. An analysis of WHO's Temporary Recommendations on international travel and trade measures during Public Health Emergencies of International Concern. BMJ Glob Health 2023; 8:e012615. [PMID: 37463788 PMCID: PMC10357756 DOI: 10.1136/bmjgh-2023-012615] [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: 04/18/2023] [Accepted: 06/25/2023] [Indexed: 07/20/2023] Open
Abstract
During Public Health Emergencies of International Concern (PHEICs), The International Health Regulations (IHR) require the WHO to issue Temporary Recommendations on the use of international travel and trade measures. During the COVID-19 pandemic, WHO's initial recommendation against 'any travel or trade restriction' has been questioned, and virtually all countries subsequently used international travel measures. WHO's Recommendations to States Parties also changed over the course of the pandemic. There is a need to understand how WHO's treatment of this issue compared with other PHEICs and why States Parties' actions diverged from WHO's initial Recommendations. This first analysis of WHO's Temporary Recommendations on international travel and trade measures during all seven PHEICs compares the guidance for clarity and consistency in several areas of substance and process. We find that lack of clarity and inconsistency in WHO guidance makes it difficult to interpret and relate back to IHR obligations. Based on this analysis, we offer recommendations to increase consistency and clarity of WHO's guidance on this issue during global health emergencies.
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Affiliation(s)
- Catherine Z Worsnop
- School of Public Policy, University of Maryland, College Park, Maryland, USA
| | - Samuel Nass
- School of Public Policy, University of Maryland, College Park, Maryland, USA
| | - Karen Ann Grépin
- School of Public Health, University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong
| | - Kelley Lee
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
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Fox A, Kim H. HIV policy legacies, pandemic preparedness and policy effort to address COVID-19. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001767. [PMID: 37363903 DOI: 10.1371/journal.pgph.0001767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 05/22/2023] [Indexed: 06/28/2023]
Abstract
That the world was unprepared for a major infectious disease outbreak is now readily apparent to all credible observers. However, some countries were more prepared than others and we have seen a variety of responses to COVID-19 emerge across nations. While recognizing that the sources of variation in country responses to COVID-19 are many and varied, in this study we seek to examine how policy legacies from national responses to HIV have influenced countries' responses to COVID-19. The aim of this study was to examine whether countries with a more conducive HIV policy environment were better prepared for COVID-19 and have therefore had more preemptive and rights-based responses. Using data from the Oxford Covid-19 Government Response Tracker, we develop measures of country effort to respond to COVID-19 including early containment and closure policies, prevention policies, economic policies, and health system policies. We combine this with data from the HIV Policy Lab and correlate overall and disaggregated country HIV Policy scores with COVID-19 Policy scores. We find that the COVID-19 Containment and Closure Measures Index was negatively correlated with supportive social policies related to HIV in the early stages of the pandemic, but the association did not persist as time went on. The COVID-19 Economic Support Measures had prolonged positive associations with supportive social policies related to HIV and negative association with clinical and treatment policies. Countries with stronger structural responses to HIV have been less inclined towards involuntary measures and more prepared for the social and economic elements of COVID-19 pandemic response.
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Affiliation(s)
- Ashley Fox
- Department of Public Administration and Policy, Rockefeller College of Public Affairs and Policy, University at Albany, Albany, NY, United States of America
| | - Heeun Kim
- Department of Public Administration and Policy, Rockefeller College of Public Affairs and Policy, University at Albany, Albany, NY, United States of America
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Hurford A, Martignoni MM, Loredo-Osti JC, Anokye F, Arino J, Husain BS, Gaas B, Watmough J. Pandemic modelling for regions implementing an elimination strategy. J Theor Biol 2023; 561:111378. [PMID: 36584747 PMCID: PMC9794400 DOI: 10.1016/j.jtbi.2022.111378] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/15/2022] [Accepted: 11/30/2022] [Indexed: 12/29/2022]
Abstract
During the COVID-19 pandemic, some countries, such as Australia, China, Iceland, New Zealand, Thailand, and Vietnam successfully implemented an elimination strategy, enacting strict border control and periods of lockdowns to end community transmission. Atlantic Canada and Canada's territories implemented similar policies, and reported long periods with no community cases. In Newfoundland and Labrador (NL), Nova Scotia, and Prince Edward Island a median of 80% or more of daily reported cases were travel-related from July 1, 2020 to May 31, 2021. With increasing vaccination coverage, it may be appropriate to exit an elimination strategy, but most existing epidemiological frameworks are applicable only to situations where most cases occur in the community, and are not appropriate for regions that have implemented an elimination strategy. To inform the pandemic response in regions that are implementing an elimination strategy, we extend importation modelling to consider post-arrival travel restrictions, and pharmaceutical and non-pharmaceutical interventions in the local community. We find that shortly after the Omicron variant had begun spreading in Canada, the expected daily number of spillovers, infections spread to NL community members from travellers and their close contacts, was higher than any time previously in the pandemic. By December 24, 2021, the expected number of spillovers was 44% higher than the previous high, which occurred in late July 2021 shortly after travel restrictions were first relaxed. We develop a method to assess the characteristics of potential future community outbreaks in regions that are implementing an elimination strategy. We apply this method to predict the effect of variant and vaccination coverage on the size of hypothetical community outbreaks in Mount Pearl, a suburb of the St. John's metropolitan area in NL. Our methodology can be used to evaluate alternative plans to relax public health restrictions when vaccine coverage is high in regions that have implemented an elimination strategy. This manuscript was submitted as part of a theme issue on "Modelling COVID-19 and Preparedness for Future Pandemics".
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Affiliation(s)
- Amy Hurford
- Memorial University of Newfoundland, Department of Biology, St. John's, NL A1C 5S7, Canada; Memorial University of Newfoundland, Mathematics and Statistics Department, St. John's, NL A1C 5S7, Canada.
| | - Maria M. Martignoni
- Memorial University of Newfoundland, Mathematics and Statistics Department, St. John’s, NL A1C 5S7, Canada
| | - J. Concepción Loredo-Osti
- Memorial University of Newfoundland, Mathematics and Statistics Department, St. John’s, NL A1C 5S7, Canada
| | - Francis Anokye
- Memorial University of Newfoundland, Department of Biology, St. John’s, NL A1C 5S7, Canada
| | - Julien Arino
- University of Manitoba, Department of Mathematics and Data Science Nexus, Winnipeg, MB R3B 2E9, Canada
| | - Bilal Saleh Husain
- University of New Brunswick, Department of Mathematics and Statistics, Fredericton, NB E3B 5A3, Canada
| | - Brian Gaas
- Government of Yukon, Department of Health and Social Services, Whitehorse, YT Y1A 3T8, Canada
| | - James Watmough
- University of New Brunswick, Department of Mathematics and Statistics, Fredericton, NB E3B 5A3, Canada
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21
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Izadi R, Hatam N, Baberi F, Yousefzadeh S, Jafari A. Economic evaluation of strategies against coronavirus: a systematic review. HEALTH ECONOMICS REVIEW 2023; 13:18. [PMID: 36933043 PMCID: PMC10024293 DOI: 10.1186/s13561-023-00430-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 03/10/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND The COVID-19 outbreak was defined as a pandemic on 11 March 2020 by the World Health Organization. After that, COVID-19 has enormously influenced health systems around the world, and it has claimed more than 4.2 million deaths until July 2021. The pandemic has led to global health, social and economic costs. This situation has prompted a crucial search for beneficial interventions and treatments, but little is known about their monetary value. This study is aimed at systematically reviewing the articles conducted on the economic evaluation of preventive, control and treatment strategies against COVID-19. MATERIAL AND METHOD We searched PubMed, Web of Science, Scopus, and Google Scholar from December 2019 to October 2021 to find applicable literature to the economic evaluation of strategies against COVID-19. Two researchers screened potentially eligible titles and abstracts. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist was used to quality assessment of studies. RESULTS Thirty-six studies were included in this review, and the average CHEERS score was 72. Cost-effectiveness analysis was the most common type of economic evaluation, used in 21 studies. And the quality-adjusted life year (QALY) was the main outcome applied to measure the effectiveness of interventions, which was used in 19 studies. In addition, articles were reported a wide range of incremental cost-effectiveness ratio (ICER), and the lowest cost per QALY ($321.14) was related to the use of vaccines. CONCLUSION Based on the results of this systematic review, it seems that all strategies are likely to be more cost-effective against COVID-19 than no intervention and vaccination was the most cost-effective strategy. This research provides insight for decision makers in choosing optimal interventions against the next waves of the current pandemic and possible future pandemics.
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Affiliation(s)
- Reyhane Izadi
- Department of Health Care Management, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nahid Hatam
- Health Human Resources Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Baberi
- Deputy of Research and Technology, School of Medicine, Shiraz University of Medical, Sciences, Shiraz, Iran
| | - Setareh Yousefzadeh
- Social Determinants of Health Research Center, Health Research Institute, Babol, University of Medical Sciences, Babol, Iran
| | - Abdosaleh Jafari
- Health Human Resources Research Centre, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
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22
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Poirier MJP, Rogers Van Katwyk S, Lin G, Hoffman SJ. Quasi-experimental evaluation of national border closures on COVID-19 transmission. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0000980. [PMID: 36962967 PMCID: PMC10021705 DOI: 10.1371/journal.pgph.0000980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 01/23/2023] [Indexed: 03/06/2023]
Abstract
With over 200 pandemic threats emerging every year, the efficacy of closing national borders to control the transmission of disease in the first months of a pandemic remains a critically important question. Previous studies offer conflicting evidence for the potential effects of these closures on COVID-19 transmission and no study has yet empirically evaluated the global impact of border closures using quasi-experimental methods and real-world data. We triangulate results from interrupted time-series analysis, meta-regression, coarsened exact matching, and an extensive series of robustness checks to evaluate the effect of 166 countries' national border closures on the global transmission of COVID-19. Total border closures banning non-essential travel from all countries and (to a lesser extent) targeted border closures banning travel from specific countries had some effect on temporarily slowing COVID-19 transmission in those countries that implemented them. In contrast to these country-level impacts, the global sum of targeted border closures implemented by February 5, 2020 was not sufficient to slow global COVID-19 transmission, but the sum of total border closures implemented by March 19, 2020 did achieve this effect. Country-level results were highly heterogeneous, with early implementation and border closures so broadly targeted that they resemble total border closures improving the likelihood of slowing the pandemic's spread. Governments that can make productive use of extra preparation time and cannot feasibly implement less restrictive alternatives might consider enacting border closures. However, given their moderate and uncertain impacts and their significant harms, border closures are unlikely to be the best policy response for most countries and should only be deployed in rare circumstances and with great caution. All countries would benefit from global mechanisms to coordinate national decisions on border closures during pandemics.
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Affiliation(s)
- Mathieu J. P. Poirier
- Global Strategy Lab, Dahdaleh Institute for Global Health Research, York University, Toronto, Canada
- School of Global Health, Faculty of Health, York University, Toronto, Canada
| | - Susan Rogers Van Katwyk
- Global Strategy Lab, Dahdaleh Institute for Global Health Research, York University, Toronto, Canada
| | - Gigi Lin
- Global Strategy Lab, Dahdaleh Institute for Global Health Research, York University, Toronto, Canada
| | - Steven J. Hoffman
- Global Strategy Lab, Dahdaleh Institute for Global Health Research, York University, Toronto, Canada
- School of Global Health, Faculty of Health, York University, Toronto, Canada
- Department of Health Research Methods, Evidence, and Impact and McMaster Health Forum, McMaster University, Hamilton, Canada
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23
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Worsnop CZ, Grépin KA, Lee K, Marion S. The Unintended Consequences of Information Provision: The World Health Organization and Border Restrictions during COVID-19. INTERNATIONAL STUDIES PERSPECTIVES 2023; 24:39-66. [PMID: 36778757 PMCID: PMC9903402 DOI: 10.1093/isp/ekac010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Why do some international agreements fail to achieve their goals? Rather than states' engaging in cheap talk, evasion, or shallow commitments, the World Health Organization's (WHO) International Health Regulations (IHR)-the agreement governing states' and WHO's response to global health emergencies-point to the unintended consequences of information provision. The IHR have a dual goal of providing public health protection from health threats while minimizing unnecessary interference in international traffic. As such, during major outbreaks WHO provides information about spread and severity, as well as guidance about how states should respond, primarily regarding border policies. During COVID-19, border restrictions such as entry restrictions, flight suspensions, and border closures have been commonplace even though WHO recommended against such policies when it declared the outbreak a public health emergency in January 2020. Building on findings from the 2014 Ebola outbreak, we argue that without raising the cost of disregarding (or the benefits of following) recommendations against border restrictions, information from WHO about outbreak spread and severity leads states to impose border restrictions inconsistent with WHO's guidance. Using new data from COVID-19, we show that WHO's public health emergency declaration and pandemic announcement are associated with increases in the number of states imposing border restrictions.
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Nwadiuko J, Bustamante AV. Little To No Correlation Found Between Immigrant Entry And COVID-19 Infection Rates In The United States. Health Aff (Millwood) 2022; 41:1635-1644. [DOI: 10.1377/hlthaff.2021.01955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Joseph Nwadiuko
- Joseph Nwadiuko , University of California Los Angeles, Los Angeles, California
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25
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Isnain AR, Che Dom N, Abdullah S, Precha N, Salim H. Efficiency of Malaysian states in managing the COVID-19 outbreak in 2020 and 2021. PLoS One 2022; 17:e0275754. [PMID: 36288385 PMCID: PMC9605290 DOI: 10.1371/journal.pone.0275754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 09/22/2022] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Many developing countries have drastically imbalanced health systems in different regions. The COVID-19 outbreak posed a further challenge as hospital structures, equipped with doctors, critical care units and respirators, were not available to a sufficient extent in all regions. OBJECTIVE This study is a descriptive study on the efficiency of Malaysian states in facing the COVID-19 outbreak. METHODOLOGY The efficiency of all Malaysian states was measured using Data Envelopment Analysis in which each state's Score of COVID Index (SCI) was quantified. The SCI of these states were then further compared between the year 2020 and 2021. A greater disparity would indicate a decline in the performance of a state over time, where nearly all the states in Malaysia experienced an increase in the score of COVID Index (SCI). RESULT This study found that the central region was the most affected, since all the three states in the region (Selangor, Federal Territory of Kuala Lumpur, and Federal Territory of Putrajaya) showed a situation of inadequacy (SCI: >0.75) due to the COVID-19 outbreak. CONCLUSION The ranking of Malaysia's states according to their vulnerability to an outbreak of COVID-19 is vitally significant for the purposes of assisting the government and policymakers in planning their responses to the outbreak and ensuring that resources are distributed appropriately.
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Affiliation(s)
- Abdul Rahim Isnain
- Centre of Environmental Health & Safety studies, Faculty of Health Sciences, Universiti Teknologi MARA (UiTM), UITM Cawangan Selangor, Puncak Alam, Selangor, Malaysia
| | - Nazri Che Dom
- Centre of Environmental Health & Safety studies, Faculty of Health Sciences, Universiti Teknologi MARA (UiTM), UITM Cawangan Selangor, Puncak Alam, Selangor, Malaysia
- Integrated Mosquito Research Group (I-MeRGe), Universiti Teknologi MARA (UiTM), UITM Cawangan Selangor, Puncak Alam, Selangor, Malaysia
- Institute for Biodiversity and Sustainable Development (IBSD), Universiti Teknologi MARA, Shah Alam, Selangor, Malaysia
- * E-mail: (HS); (NCD)
| | - Samsuri Abdullah
- Faculty of Ocean Engineering Technology and Informatics, Universiti Malaysia Terengganu, Kuala Nerus, Terengganu, Malaysia
| | - Nopadol Precha
- Department of Environmental Health and Technology, School of Public Health, Walailak University, Nakhon Si Thammarat, Thailand
| | - Hasber Salim
- School of Biological Sciences, Universiti Sains Malaysia, Minden Penang, Malaysia
- * E-mail: (HS); (NCD)
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26
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Stanford V, Gresh L, Toledo J, Méndez J, Aldighieri S, Reveiz L. Evidence in decision-making in the context of COVID-19 in Latin America. THE LANCET REGIONAL HEALTH - AMERICAS 2022; 14:100322. [PMID: 35879980 PMCID: PMC9299752 DOI: 10.1016/j.lana.2022.100322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background The pace of the COVID-19 pandemic poses an unprecedented challenge to the evidence-to-decision process. Latin American countries have responded to COVID-19 by introducing interventions to both mitigate the risk of infection and to treat cases. Understanding how evidence is used to inform government-level decision-making at a national scale is crucial for informing country and regional actors in ongoing response efforts. Objectives This study was undertaken between February-May 2021 and aims to characterise the best available evidence (BAE) and assess the extent to which it was used to inform decision-making in 21 Latin American countries, in relation to pharmaceutical (PI) and non-pharmaceutical interventions (NPI) related to COVID-19, including the use of therapeutics (corticosteroids, hydroxychloroquine/chloroquine and ivermectin), facemask use in the community setting and the use of diagnostic tests as a requirement for international travel. Method A three-phase methodology was used to; (i) characterise the BAE for each intervention using an umbrella review, (ii) identify government-level decisions for each intervention through a document review and (iii) assess the use of evidence to inform decisions using a novel adapted framework analysis. Findings The BAE is characterized by 17 living and non-living systematic reviews as evolving, and particularly uncertain for NPIs. 107 country-level documents show variation in both content and timing of decision outcomes across intervention types, with the majority of decisions taken at a time of evidence uncertainty, with only 5 documents including BAE. Seven out of eight key indicators of an evidence-to-decision process were identified more frequently among PIs than either NPI of facemask use or testing prior to travel. Overall evidence use was reported more frequently among PIs than either NPI of facemask use or travel testing (92%, 28% and 29%, respectively). Interpretation There are limitations in the extent to which evidence use in decision-making is reported across the Latin America region. Institutionalising this process and grounding it in existing and emerging methodologies can facilitate the rapid response in an emergency setting. Funding No funding was sourced for this work.
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Affiliation(s)
- Victoria Stanford
- Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC, USA
| | - Lionel Gresh
- Incident Management System for the Covid-19 Response. Pan American Health Organization, Washington, DC, USA
- Department of Health Emergencies, Pan American Health Organization, Washington, DC, USA
| | - Joao Toledo
- Incident Management System for the Covid-19 Response. Pan American Health Organization, Washington, DC, USA
- Department of Health Emergencies, Pan American Health Organization, Washington, DC, USA
| | - Jairo Méndez
- Incident Management System for the Covid-19 Response. Pan American Health Organization, Washington, DC, USA
- Department of Health Emergencies, Pan American Health Organization, Washington, DC, USA
| | - Sylvain Aldighieri
- Incident Management System for the Covid-19 Response. Pan American Health Organization, Washington, DC, USA
- Department of Health Emergencies, Pan American Health Organization, Washington, DC, USA
| | - Ludovic Reveiz
- Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC, USA
- Incident Management System for the Covid-19 Response. Pan American Health Organization, Washington, DC, USA
- Corresponding author at: Pan American Health Organization, 525 23rd St, NW, Washington DC 20037-2895, USA.
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27
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Choi Y, Zou L, Dresner M. The effects of air transport mobility and global connectivity on viral transmission: Lessons learned from Covid-19 and its variants. TRANSPORT POLICY 2022; 127:22-30. [PMID: 36035455 PMCID: PMC9391984 DOI: 10.1016/j.tranpol.2022.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 07/13/2022] [Accepted: 08/15/2022] [Indexed: 05/12/2023]
Abstract
We investigate the impact of air travel mobility and global connectivity on viral transmission by tracing the announced arrival time of COVID-19 and its major variants in countries around the world. We find that air travel intensity to a country, "effective distance" as measured by international air traffic, is generally a significant predictor for the announced viral arrival time. The level of healthcare infrastructure in a country is less important at predicting the initial transmission and detection time of a virus. A policy variable, notably the percentage reduction of total inbound seats in response to a viral outbreak, is largely ineffective at delaying viral transmission and discovery time. These findings suggest that air network connectivity is a major contributor to the speed of viral transmission. However, government attempts to delay viral transmission by reducing air network connectivity after the virus is first discovered are largely ineffective.
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Affiliation(s)
- Youngran Choi
- David B. O'Maley College of Business, Embry-Riddle Aeronautical University, 1 Aerospace Boulevard, Daytona Beach, FL, 32114, USA
| | - Li Zou
- David B. O'Maley College of Business, Embry-Riddle Aeronautical University, 1 Aerospace Boulevard, Daytona Beach, FL, 32114, USA
| | - Martin Dresner
- Logistics, Business & Public Policy, R.H. Smith School of Business, University of Maryland, College Park, MD, 20742, USA
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28
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Duckett S. Public Health Management of the COVID-19 Pandemic in Australia: The Role of the Morrison Government. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10400. [PMID: 36012035 PMCID: PMC9407931 DOI: 10.3390/ijerph191610400] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/17/2022] [Accepted: 08/17/2022] [Indexed: 05/24/2023]
Abstract
The Australian Commonwealth government has four health-related responsibilities during the SARS-CoV-2 pandemic: to provide national leadership; to manage external borders; to protect residents of residential aged care facilities; and to approve, procure and roll-out tests and vaccines. State governments are responsible for determining what public health measures are appropriate and implementing them-including managing the border quarantine arrangements and the testing, tracing, and isolation regime-and managing the hospital response. This paper analyses the national government's response to the pandemic and discusses why it has attracted a thesaurus of negative adjectives.
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Affiliation(s)
- Stephen Duckett
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia
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29
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Parker E, Anderson C, Zeller M, Tibi A, Havens JL, Laroche G, Benlarbi M, Ariana A, Robles-Sikisaka R, Latif AA, Watts A, Awidi A, Jaradat SA, Gangavarapu K, Ramesh K, Kurzban E, Matteson NL, Han AX, Hughes LD, McGraw M, Spencer E, Nicholson L, Khan K, Suchard MA, Wertheim JO, Wohl S, Côté M, Abdelnour A, Andersen KG, Abu-Dayyeh I. Regional connectivity drove bidirectional transmission of SARS-CoV-2 in the Middle East during travel restrictions. Nat Commun 2022; 13:4784. [PMID: 35970983 PMCID: PMC9376901 DOI: 10.1038/s41467-022-32536-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 08/04/2022] [Indexed: 01/02/2023] Open
Abstract
Regional connectivity and land travel have been identified as important drivers of SARS-CoV-2 transmission. However, the generalizability of this finding is understudied outside of well-sampled, highly connected regions. In this study, we investigated the relative contributions of regional and intercontinental connectivity to the source-sink dynamics of SARS-CoV-2 for Jordan and the Middle East. By integrating genomic, epidemiological and travel data we show that the source of introductions into Jordan was dynamic across 2020, shifting from intercontinental seeding in the early pandemic to more regional seeding for the travel restrictions period. We show that land travel, particularly freight transport, drove introduction risk during the travel restrictions period. High regional connectivity and land travel also drove Jordan's export risk. Our findings emphasize regional connectedness and land travel as drivers of transmission in the Middle East.
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Affiliation(s)
- Edyth Parker
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, USA.
| | - Catelyn Anderson
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, USA
| | - Mark Zeller
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, USA
| | - Ahmad Tibi
- Biolab Diagnostic Laboratories, Amman, Jordan
| | - Jennifer L Havens
- Bioinformatics and Systems Biology Graduate Program, University of California San Diego, La Jolla, CA, USA
| | - Geneviève Laroche
- Department of Biochemistry, Microbiology and Immunology, and Center for Infection, Immunity, and Inflammation, University of Ottawa, Ottawa, ON, Canada
| | - Mehdi Benlarbi
- Department of Biochemistry, Microbiology and Immunology, and Center for Infection, Immunity, and Inflammation, University of Ottawa, Ottawa, ON, Canada
| | - Ardeshir Ariana
- Department of Biochemistry, Microbiology and Immunology, and Center for Infection, Immunity, and Inflammation, University of Ottawa, Ottawa, ON, Canada
| | - Refugio Robles-Sikisaka
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, USA
| | - Alaa Abdel Latif
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, USA
| | | | - Abdalla Awidi
- Cell Therapy Center, The University of Jordan, Amman, Jordan
- Thrombosis, haemostasis laboratory, School of Medicine, The University of Jordan, Amman, Jordan
| | - Saied A Jaradat
- Princess Haya Biotechnology Center, Jordan University of Science and Technology, Irbid, Jordan
| | - Karthik Gangavarapu
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Karthik Ramesh
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, USA
| | - Ezra Kurzban
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, USA
| | - Nathaniel L Matteson
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, USA
| | - Alvin X Han
- Department of Medical Microbiology & Infection Prevention, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
| | - Laura D Hughes
- Department of Integrative, Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - Michelle McGraw
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, USA
| | - Emily Spencer
- Scripps Research Translational Institute, La Jolla, CA, USA
| | | | | | - Marc A Suchard
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Joel O Wertheim
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Shirlee Wohl
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, USA
| | - Marceline Côté
- Department of Biochemistry, Microbiology and Immunology, and Center for Infection, Immunity, and Inflammation, University of Ottawa, Ottawa, ON, Canada
| | | | - Kristian G Andersen
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, USA
| | - Issa Abu-Dayyeh
- Biolab Diagnostic Laboratories, Amman, Jordan.
- Cell Therapy Center, The University of Jordan, Amman, Jordan.
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Brackx F, Vanongeval F, Natalia YA, Molenberghs G, Steenberghen T. The Effect of Transborder Mobility on COVID-19 Incidences in Belgium. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9968. [PMID: 36011602 PMCID: PMC9408231 DOI: 10.3390/ijerph19169968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/08/2022] [Accepted: 08/10/2022] [Indexed: 06/15/2023]
Abstract
Belgium is a geographically small country bordered by The Netherlands, France, Germany, and Luxembourg, with intense transborder mobility, defined as mobility in the border regions with neighboring countries. It is therefore of interest to examine how the 14-day COVID-19 confirmed case incidence in the border regions is influenced by that of the adjacent regions in the neighboring countries and thus, whether and how it differs from that in the adjacent non-border regions within Belgium. To this end, the 14-day COVID-19 confirmed case incidence is studied at the level of Belgian provinces, well-defined border areas within Belgium, and adjacent regions in the neighboring countries. Auxiliary information encompasses work-related border traffic, travel rates, the proportion of people with a different nationality, the stringency index of the non-pharmaceutical interventions, and the degree of urbanization at the level of the municipality. Especially in transnational urbanized areas such as between the Belgian and Dutch provinces of Limburg and between the Belgian province of Antwerp and the Dutch province of North Brabant, the impact on incidence is visible, at least at some points in time, especially when the national incidences differ between neighboring countries. In contrast, the intra-Belgian language border regions show very little transborder impact on the incidence curves, except around the Brussels capital region, leading to various periods where the incidences are very different in the Dutch-speaking north and the French-speaking south of Belgium. Our findings suggest that while travel restrictions may be needed at some points during a pandemic, a more fine-grained approach than merely closing national borders may be considered. At the same time, in border regions with considerable transborder mobility, it is recommended to coordinate the non-pharmaceutical interventions between the authorities of the various countries overlapping with the border region. While this seems logical, there are clear counterexamples, e.g., where non-essential shops, restaurants, and bars are closed in one country but not in the neighboring country.
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Affiliation(s)
- Febe Brackx
- Spatial Applications Division, KU Leuven, 3000 Leuven, Belgium
| | - Fien Vanongeval
- Spatial Applications Division, KU Leuven, 3000 Leuven, Belgium
| | | | - Geert Molenberghs
- Spatial Applications Division, KU Leuven, 3000 Leuven, Belgium
- I-Biostat, Data Science Institute, Universiteit Hasselt, 3500 Hasselt, Belgium
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31
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Zhong L, Zhou Y, Gao S, Yu Z, Ma Z, Li X, Yue Y, Xia J. COVID-19 lockdown introduces human mobility pattern changes for both Guangdong-Hong Kong-Macao greater bay area and the San Francisco bay area. INTERNATIONAL JOURNAL OF APPLIED EARTH OBSERVATION AND GEOINFORMATION : ITC JOURNAL 2022; 112:102848. [PMID: 35757462 PMCID: PMC9212878 DOI: 10.1016/j.jag.2022.102848] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/15/2022] [Accepted: 05/27/2022] [Indexed: 06/15/2023]
Abstract
In response to the coronavirus disease 2019 (COVID-19) pandemic, various countries have sought to control COVID-19 transmission by introducing non-pharmaceutical interventions. Restricting population mobility, by introducing social distancing, is one of the most widely used non-pharmaceutical interventions. Although similar population mobility restriction interventions were introduced, their impacts on COVID-19 transmission are often inconsistent across different regions and different time periods. These differences may provide critical information for tailoring COVID-19 control strategies. In this paper, anonymized high spatiotemporal resolution mobile-phone location data were employed to empirically analyze and quantify the impact of lockdowns on population mobility. Both the Guangdong-Hong Kong-Macao Greater Bay Area (GBA) in China and the San Francisco Bay Area (SBA) in the United States were studied. In response to the lockdowns, a general reduction in population mobility was observed, but the structural changes in mobility are very different between the two bays: 1) GBA mobility decreased by approximately 74.0-80.1% while the decrease of SBA was about 25.0-42.1%; 2) compared to SBA, the GBA had smoother volatility in daily volume during the lockdown. The volatility change indexes for GBA and SBA were 2.55% and 7.52%, respectively; 3) the effect of lockdown on short- to long-distance mobility was similar in GBA while the medium- and long-distance impact was more pronounced in SBA.
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Affiliation(s)
- Leiyang Zhong
- Guangdong Key Laboratory of Urban Informatics, and Shenzhen Key Laboratory of Spatial Smart Sensing and Service, School of Architecture and Urban Planning, Shenzhen University, Shenzhen 518060, China
- Ministry of Natural Resources (MNR), Key Laboratory for Geo-Environmental Monitoring of Great Bay Area, Shenzhen University, Shenzhen 518060, China
| | - Ying Zhou
- College of Public Health, Shenzhen University, Shenzhen 518060, China
| | - Song Gao
- Geospatial Data Science Lab, Department of Geography, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Zhaoyang Yu
- Guangdong Key Laboratory of Urban Informatics, and Shenzhen Key Laboratory of Spatial Smart Sensing and Service, School of Architecture and Urban Planning, Shenzhen University, Shenzhen 518060, China
- Ministry of Natural Resources (MNR), Key Laboratory for Geo-Environmental Monitoring of Great Bay Area, Shenzhen University, Shenzhen 518060, China
| | - Zhifeng Ma
- Guangdong Key Laboratory of Urban Informatics, and Shenzhen Key Laboratory of Spatial Smart Sensing and Service, School of Architecture and Urban Planning, Shenzhen University, Shenzhen 518060, China
- Ministry of Natural Resources (MNR), Key Laboratory for Geo-Environmental Monitoring of Great Bay Area, Shenzhen University, Shenzhen 518060, China
| | - Xiaoming Li
- Guangdong Key Laboratory of Urban Informatics, and Shenzhen Key Laboratory of Spatial Smart Sensing and Service, School of Architecture and Urban Planning, Shenzhen University, Shenzhen 518060, China
- Ministry of Natural Resources (MNR), Key Laboratory for Geo-Environmental Monitoring of Great Bay Area, Shenzhen University, Shenzhen 518060, China
| | - Yang Yue
- Guangdong Key Laboratory of Urban Informatics, and Shenzhen Key Laboratory of Spatial Smart Sensing and Service, School of Architecture and Urban Planning, Shenzhen University, Shenzhen 518060, China
- Ministry of Natural Resources (MNR), Key Laboratory for Geo-Environmental Monitoring of Great Bay Area, Shenzhen University, Shenzhen 518060, China
| | - Jizhe Xia
- Guangdong Key Laboratory of Urban Informatics, and Shenzhen Key Laboratory of Spatial Smart Sensing and Service, School of Architecture and Urban Planning, Shenzhen University, Shenzhen 518060, China
- Ministry of Natural Resources (MNR), Key Laboratory for Geo-Environmental Monitoring of Great Bay Area, Shenzhen University, Shenzhen 518060, China
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Poirier MJP, Viens AM, Penney TL, Rogers Van Katwyk S, Astbury CC, Lin G, Nanyangwe-Moyo T, Hoffman SJ. Principles and methods of global legal epidemiology. J Epidemiol Community Health 2022; 76:jech-2021-217202. [PMID: 35705361 PMCID: PMC9380495 DOI: 10.1136/jech-2021-217202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 05/29/2022] [Indexed: 11/24/2022]
Abstract
Although the theory and methods of legal epidemiology-the scientific study and deployment of law as a factor in the cause, distribution, and prevention of disease and injury in a population-have been well developed in the context of domestic law, the challenges posed by shifting the frame of analysis to the global legal space have not yet been fully explored. While legal epidemiology rests on the foundational principles that law acts as an intervention, that law can be an object of scientific study and that law has impacts that should be evaluated, its application to the global level requires the recognition that international laws, policies and norms can cause effects independently from their legal implementation within countries. The global legal space blurs distinctions between 'hard' and 'soft' law, often operating through pathways of global agenda setting, legal language, political pressures, social mobilisation and trade pressures to have direct impacts on people, places and products. Despite these complexities, international law has been overwhelmingly studied as operating solely through national policy change, with only one global quasi-experimental evaluation of an international law's impact on health published to date. To promote greater adoption of global legal epidemiology, we expand on an existing typology of public health law studies with examples of policymaking, mapping, implementation, intervention and mechanism studies. Global legal epidemiology holds great promise as a way to produce rigorous and impactful research on the international laws, policies and norms that shape our collective health, equity and well-being.
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Affiliation(s)
- Mathieu J P Poirier
- Global Strategy Lab, Dahdaleh Institute for Global Health Research, York University, Toronto, Ontario, Canada
- School of Global Health, York University, Toronto, Ontario, Canada
| | - A M Viens
- Global Strategy Lab, Dahdaleh Institute for Global Health Research, York University, Toronto, Ontario, Canada
- School of Global Health, York University, Toronto, Ontario, Canada
| | - Tarra L Penney
- Global Strategy Lab, Dahdaleh Institute for Global Health Research, York University, Toronto, Ontario, Canada
- School of Global Health, York University, Toronto, Ontario, Canada
| | - Susan Rogers Van Katwyk
- Global Strategy Lab, Dahdaleh Institute for Global Health Research, York University, Toronto, Ontario, Canada
| | - Chloe C Astbury
- Global Strategy Lab, Dahdaleh Institute for Global Health Research, York University, Toronto, Ontario, Canada
- School of Global Health, York University, Toronto, Ontario, Canada
| | - Gigi Lin
- Global Strategy Lab, Dahdaleh Institute for Global Health Research, York University, Toronto, Ontario, Canada
| | - Tina Nanyangwe-Moyo
- Global Strategy Lab, Dahdaleh Institute for Global Health Research, York University, Toronto, Ontario, Canada
| | - Steven J Hoffman
- Global Strategy Lab, Dahdaleh Institute for Global Health Research, York University, Toronto, Ontario, Canada
- School of Global Health, York University, Toronto, Ontario, Canada
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Schäfer M, Wijaya KP, Rockenfeller R, Götz T. The impact of travelling on the COVID-19 infection cases in Germany. BMC Infect Dis 2022; 22:455. [PMID: 35549671 PMCID: PMC9096785 DOI: 10.1186/s12879-022-07396-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 04/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND COVID-19 continues to disrupt social lives and the economy of many countries and challenges their healthcare capacities. Looking back at the situation in Germany in 2020, the number of cases increased exponentially in early March. Social restrictions were imposed by closing e.g. schools, shops, cafés and restaurants, as well as borders for travellers. This reaped success as the infection rate descended significantly in early April. In mid July, however, the numbers started to rise again. Of particular reasons was that from mid June onwards, the travel ban has widely been cancelled or at least loosened. We aim to measure the impact of travellers on the overall infection dynamics for the case of (relatively) few infectives and no vaccinations available. We also want to analyse under which conditions political travelling measures are relevant, in particular in comparison to local measures. By travel restrictions in our model we mean all possible measures that equally reduce the possibility of infected returnees to further spread the disease in Germany, e.g. travel bans, lockdown, post-arrival tests and quarantines. METHODS To analyse the impact of travellers, we present three variants of an susceptible-exposed-infected-recovered-deceased model to describe disease dynamics in Germany. Epidemiological parameters such as transmission rate, lethality, and detection rate of infected individuals are incorporated. We compare a model without inclusion of travellers and two models with a rate measuring the impact of travellers incorporating incidence data from the Johns Hopkins University. Parameter estimation was performed with the aid of the Monte-Carlo-based Metropolis algorithm. All models are compared in terms of validity and simplicity. Further, we perform sensitivity analyses of the model to observe on which of the model parameters show the largest influence the results. In particular, we compare local and international travelling measures and identify regions in which one of these shows larger relevance than the other. RESULTS In the comparison of the three models, both models with the traveller impact rate yield significantly better results than the model without this rate. The model including a piecewise constant travel impact rate yields the best results in the sense of maximal likelihood and minimal Bayesian Information Criterion. We synthesize from model simulations and analyses that travellers had a strong impact on the overall infection cases in the considered time interval. By a comparison of the reproductive ratios of the models under traveller/no-traveller scenarios, we found that higher traveller numbers likely induce higher transmission rates and infection cases even in the further course, which is one possible explanation to the start of the second wave in Germany as of autumn 2020. The sensitivity analyses show that the travelling parameter, among others, shows a larger impact on the results. We also found that the relevance of travel measures depends on the value of the transmission parameter: In domains with a lower transmission parameter, caused either by the current variant or local measures, it is found that handling the travel parameters is more relevant than those with lower value of the transmission. CONCLUSIONS We conclude that travellers is an important factor in controlling infection cases during pandemics. Depending on the current situation, travel restrictions can be part of a policy to reduce infection numbers, especially when case numbers and transmission rate are low. The results of the sensitivity analyses also show that travel measures are more effective when the local transmission is already reduced, so a combination of those two appears to be optimal. In any case, supervision of the influence of travellers should always be undertaken, as another pandemic or wave can happen in the upcoming years and vaccinations and basic hygiene rules alone might not be able to prevent further infection waves.
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Affiliation(s)
- Moritz Schäfer
- Mathematical Institute, University of Koblenz-Landau, 56070, Koblenz, Germany.
| | | | - Robert Rockenfeller
- Mathematical Institute, University of Koblenz-Landau, 56070, Koblenz, Germany
| | - Thomas Götz
- Mathematical Institute, University of Koblenz-Landau, 56070, Koblenz, Germany
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Le TM, Raynal L, Talbot O, Hambridge H, Drovandi C, Mira A, Mengersen K, Onnela JP. Framework for assessing and easing global COVID-19 travel restrictions. Sci Rep 2022; 12:6985. [PMID: 35484268 PMCID: PMC9049014 DOI: 10.1038/s41598-022-10678-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 04/11/2022] [Indexed: 11/30/2022] Open
Abstract
During the COVID-19 pandemic, many countries implemented international travel restrictions that aimed to contain viral spread while still allowing necessary cross-border travel for social and economic reasons. The relative effectiveness of these approaches for controlling the pandemic has gone largely unstudied. Here we developed a flexible network meta-population model to compare the effectiveness of international travel policies, with a focus on evaluating the benefit of policy coordination. Because country-level epidemiological parameters are unknown, they need to be estimated from data; we accomplished this using approximate Bayesian computation, given the nature of our complex stochastic disease transmission model. Based on simulation and theoretical insights we find that, under our proposed policy, international airline travel may resume up to 58% of the pre-pandemic level with pandemic control comparable to that of a complete shutdown of all airline travel. Our results demonstrate that global coordination is necessary to allow for maximum travel with minimum effect on viral spread.
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Affiliation(s)
- Thien-Minh Le
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Louis Raynal
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Octavious Talbot
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Hali Hambridge
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Christopher Drovandi
- School of Mathematical Sciences, Faculty of Science, Queensland University Technology, Brisbane, Australia
| | | | - Kerrie Mengersen
- School of Mathematical Sciences, Faculty of Science, Queensland University Technology, Brisbane, Australia
| | - Jukka-Pekka Onnela
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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Schermerhorn J, Case A, Graeden E, Kerr J, Moore M, Robinson-Marshall S, Wallace T, Woodrow E, Katz R. Fifteen days in December: capture and analysis of Omicron-related travel restrictions. BMJ Glob Health 2022; 7:bmjgh-2022-008642. [PMID: 35296466 PMCID: PMC8928247 DOI: 10.1136/bmjgh-2022-008642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 02/21/2022] [Indexed: 11/04/2022] Open
Abstract
Following the identification of the Omicron variant of the SARS-CoV-2 virus in late November 2021, governments worldwide took actions intended to minimise the impact of the new variant within their borders. Despite guidance from the WHO advising a risk-based approach, many rapidly implemented stringent policies focused on travel restrictions. In this paper, we capture 221 national-level travel policies issued during the 3 weeks following publicisation of the Omicron variant. We characterise policies based on whether they target travellers from specific countries or focus more broadly on enhanced screening, and explore differences in approaches at the regional level. We find that initial reactions almost universally focused on entry bans and flight suspensions from Southern Africa, and that policies continued to target travel from these countries even after community transmission of the Omicron variant was detected elsewhere in the world. While layered testing and quarantine requirements were implemented by some countries later in this 3-week period, these enhanced screening policies were rarely the first response. The timing and conditionality of quarantine and testing requirements were not coordinated between countries or regions, creating logistical complications and burdening travellers with costs. Overall, response measures were rarely tied to specific criteria or adapted to match the unique epidemiology of the new variant.
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Affiliation(s)
- Jordan Schermerhorn
- Center for Global Health Science and Security, Georgetown University, Washington, District of Columbia, USA
| | | | - Ellie Graeden
- Center for Global Health Science and Security, Georgetown University, Washington, District of Columbia, USA.,Talus Analytics, Boulder, Colorado, USA
| | - Justin Kerr
- Talus Analytics, Washington, District of Columbia, USA
| | - Mackenzie Moore
- Center for Global Health Science and Security, Georgetown University, Washington, District of Columbia, USA
| | - Siobhan Robinson-Marshall
- Center for Global Health Science and Security, Georgetown University, Washington, District of Columbia, USA
| | | | - Emily Woodrow
- Center for Global Health Science and Security, Georgetown University, Washington, District of Columbia, USA
| | - Rebecca Katz
- Center for Global Health Science and Security, Georgetown University, Washington, District of Columbia, USA
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Effectiveness of Human Mobility Change in Reducing the Spread of COVID-19: Ecological Study of Kingdom of Saudi Arabia. SUSTAINABILITY 2022. [DOI: 10.3390/su14063368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Non-pharmacological interventions including mobility restriction have been developed to curb transmission of SARS-CoV-2. We provided precise estimates of disease burden and examined the impact of mobility restriction on reducing the COVID-19 effective reproduction number in the Kingdom of Saudi Arabia. This study involved secondary analysis of open-access COVID-19 data obtained from different sources between 2 March and 26 December 2020. The dependent and main independent variables of interest were the effective reproduction number and anonymized mobility indices, respectively. Multiple linear regression was used to investigate the relationship between the community mobility change and the effective reproduction number for COVID-19. By 26 December 2020, the total number of COVID-19 cases in Saudi Arabia reached 360,690, with a cumulative incidence rate of 105.41/10,000 population. Al Jouf, Northern Border, and Jazan regions were ≥2.5 times (OR = 2.93; 95% CI: 1.29–6.64), (OR = 2.50; 95% CI: 1.08–5.81), and (OR = 2.51; 95% CI: 1.09–5.79) more likely to have a higher case fatality rate than Riyadh, the capital. Mobility changes in public and residential areas were significant predictors of the COVID-19 effective reproduction number. This study demonstrated that community mobility restrictions effectively control transmission of the COVID-19 virus.
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Dunn RR, Burger JR, Carlen EJ, Koltz AM, Light JE, Martin RA, Munshi-South J, Nichols LM, Vargo EL, Yitbarek S, Zhao Y, Cibrián-Jaramillo A. A Theory of City Biogeography and the Origin of Urban Species. FRONTIERS IN CONSERVATION SCIENCE 2022. [DOI: 10.3389/fcosc.2022.761449] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Many of the choices humans make with regard to infrastructure, urban planning and other phenomena have impacts that will last thousands of years. This can readily be seen in modern cities in which contemporary streets run along street grids that were laid out thousands of years prior or even in which ancient viaducts still play a role. However, rarely do evolutionary biologists explicitly consider the future of life likely to be associated with the decisions we are making today. Here, we consider the evolutionary future of species in cities with a focus on the origin of lineages and species. We do so by adjusting evolutionary predictions from the theory of island biogeography so as to correspond to the unique features of cities as islands. Specifically, the species endemic to cities tend to be associated with the gray habitats in cities. Those habitats tend to be dominated by human bodies, pet bodies and stored food. It is among such species where the origin of new lineages is most likely, although most research on evolution in cities has focused on green habitats. We conclude by considering a range of scenarios for the far future and their implications for the origin of lineages and species.
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Lai D, Cai Y, Chan TH, Gan D, Hurson AN, Zhang YD. How to organise travel restrictions in the new future: lessons from the COVID-19 response in Hong Kong and Singapore. BMJ Glob Health 2022; 7:bmjgh-2021-006975. [PMID: 35228258 PMCID: PMC8886091 DOI: 10.1136/bmjgh-2021-006975] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 02/01/2022] [Indexed: 12/12/2022] Open
Abstract
It has been nearly 2 years since the first case of COVID-19 was reported. Governments worldwide have introduced numerous non-pharmaceutical interventions (NPIs) to combat this disease. Many of these NPIs were designed in response to initial outbreaks but are unsustainable in the long term. Governments are exploring how to adjust their current NPIs to resume normal activities while effectively protecting their population. As one of the most controversial NPIs, the implementation of travel restrictions varies across regions. Some governments have abandoned their previous travel restrictions because of the induced costs to society and on the economy. Other areas, including Hong Kong (Special Administrative Region of China) and Singapore, continue employing these NPIs as a long-term disease prevention tactic. However, the multidimensional impacts of travel restrictions require careful consideration of how to apply restrictions more appropriately. We have proposed an adapted framework to examine Hong Kong and Singapore’s travel restrictions. We aimed to study these two regions’ experiences in balancing disease control efforts with easing the burden on lives and livelihoods. Based on the experiences of Hong Kong and Singapore, we have outlined six policy recommendations to serve as the cornerstone for future research and policy practices.
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Affiliation(s)
- Daoyuan Lai
- Department of Statistics and Actuarial Science, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Yuxi Cai
- Department of Statistics and Actuarial Science, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Tsai Hor Chan
- Department of Statistics and Actuarial Science, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Dailin Gan
- Department of Applied and Computational Mathematics and Statistics, University of Notre Dame, Notre Dame, Indiana, USA
| | - Amber N Hurson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Yan Dora Zhang
- Department of Statistics and Actuarial Science, The University of Hong Kong, Hong Kong SAR, People's Republic of China .,Centre for PanorOmic Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
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Uthman OA, Adetokunboh OO, Wiysonge CS, Al-Awlaqi S, Hanefeld J, El Bcheraoui C. Classification Schemes of COVID-19 High Risk Areas and Resulting Policies: A Rapid Review. Front Public Health 2022; 10:769174. [PMID: 35284361 PMCID: PMC8916531 DOI: 10.3389/fpubh.2022.769174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/20/2022] [Indexed: 11/13/2022] Open
Abstract
The COVID-19 pandemic has posed a significant global health threat since January 2020. Policies to reduce human mobility have been recognized to effectively control the spread of COVID-19; although the relationship between mobility, policy implementation, and virus spread remains contentious, with no clear pattern for how countries classify each other, and determine the destinations to- and from which to restrict travel. In this rapid review, we identified country classification schemes for high-risk COVID-19 areas and associated policies which mirrored the dynamic situation in 2020, with the aim of identifying any patterns that could indicate the effectiveness of such policies. We searched academic databases, including PubMed, Scopus, medRxiv, Google Scholar, and EMBASE. We also consulted web pages of the relevant government institutions in all countries. This rapid review's searches were conducted between October 2020 and December 2021. Web scraping of policy documents yielded additional 43 country reports on high-risk area classification schemes. In 43 countries from which relevant reports were identified, six issued domestic classification schemes. International classification schemes were issued by the remaining 38 countries, and these mainly used case incidence per 100,000 inhabitants as key indicator. The case incidence cut-off also varied across the countries, ranging from 20 cases per 100,000 inhabitants in the past 7 days to more than 100 cases per 100,000 inhabitants in the past 28 days. The criteria used for defining high-risk areas varied across countries, including case count, positivity rate, composite risk scores, community transmission and satisfactory laboratory testing. Countries either used case incidence in the past 7, 14 or 28 days. The resulting policies included restrictions on internal movement and international travel. The quarantine policies can be summarized into three categories: (1) 14 days self-isolation, (2) 10 days self-isolation and (3) 14 days compulsory isolation.
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Affiliation(s)
- Olalekan A. Uthman
- Warwick Centre for Global Health Research, The University of Warwick, Coventry, United Kingdom
| | - Olatunji O. Adetokunboh
- South African Centre for Epidemiological Modelling and Analysis, Stellenbosch University, Stellenbosch, South Africa
- Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, South Africa
| | - Charles Shey Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Sameh Al-Awlaqi
- Evidence-Based Public Health, Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Johanna Hanefeld
- Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Charbel El Bcheraoui
- Evidence-Based Public Health, Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
- *Correspondence: Charbel El Bcheraoui
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Budrie L, Narinesingh A. Locked out: An ethical analysis of Trinidad and Tobago's COVID-19 border closure. ETHICS, MEDICINE, AND PUBLIC HEALTH 2022; 20:100749. [PMID: 34901364 PMCID: PMC8648578 DOI: 10.1016/j.jemep.2021.100749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/29/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The COVID-19 pandemic has forced nearly every nation around the world to implement border restrictions, some of which have prevented citizens from entering their own country. Restricting access to one's own country was a burdensome intervention, but may have been necessary given the global emergency. Thus, the decision restrict citizens' entry as a public health intervention warrants ethical analysis to determine its appropriateness. The focus of this paper is on the ethics of the 15-month border closure implemented in Trinidad and Tobago during the COVID-19 pandemic. METHODOLOGY Ethical analysis of the COVID-19 border closure in Trinidad and Tobago was done using a six-part ethical framework for public health. DISCUSSION The ethical analysis highlights various areas of concern which question the justification for the border closure. The effectiveness, necessity and proportionality of the intervention were justified in the short-term, however, as benefits diminished over time, this did not result in appropriate policy changes. Continuous evaluation of the intervention throughout its use could have improved the balance of benefits and burdens thereby providing stronger ethical validation. CONCLUSION The COVID-19 border closure in Trinidad and Tobago brought substantial burdens upon its citizens without comparable benefits. Data from previous pandemics and the best available data during the current pandemic showed that effectiveness was limited to the initial months, after which it would have been unnecessary to maintain. Thus, the government's decision to prolong the border closure for 15 months, well past its time of effectiveness, was not ethically justified from our analysis.
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Affiliation(s)
- L Budrie
- Department of Microbiology, Immunology and Pharmacology, St. George's University School of Medicine, True Blue, St. George, Grenada
- Faculty of Bioethics, Anáhuac University, México
| | - A Narinesingh
- Department of Physiology, Neuroscience and Behavioural Sciences, St. George's University School of Medicine, St. George, Grenada
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Abstract
Despite the economic, social, and humanitarian costs of border closures, more than 1000 new international border closures were introduced in response to the 2020-2021 pandemic by nearly every country in the world. The objective of this study was to examine whether these border closures reduced the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Prior to 2020, the impacts of border closures on disease spread were largely unknown, and their use as a pandemic policy was advised against by international organizations. We tested whether they were helpful in reducing spread by using matching techniques on our hand-coded COVID Border Accountability Project (COBAP) Team database of international closures, converted to a time-series cross-sectional data format. We controlled for national-level internal movement restrictions (domestic lockdowns) using the Oxford COVID-19 Government Response Tracker (OxCGRT) time-series data. We found no evidence in favor of international border closures, whereas we found a strong association between national-level lockdowns and a reduced spread of SARS-CoV-2 cases. More research must be done to evaluate the byproduct effects of closures versus lockdowns as well as the efficacy of other preventative measures introduced at international borders.
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Tao S, Bragazzi NL, Wu J, Mellado B, Kong JD. Harnessing Artificial Intelligence to assess the impact of nonpharmaceutical interventions on the second wave of the Coronavirus Disease 2019 pandemic across the world. Sci Rep 2022; 12:944. [PMID: 35042945 PMCID: PMC8766477 DOI: 10.1038/s41598-021-04731-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 12/23/2021] [Indexed: 02/07/2023] Open
Abstract
In the present paper, we aimed to determine the influence of various non-pharmaceutical interventions (NPIs) enforced during the first wave of COVID-19 across countries on the spreading rate of COVID-19 during the second wave. For this purpose, we took into account national-level climatic, environmental, clinical, health, economic, pollution, social, and demographic factors. We estimated the growth of the first and second wave across countries by fitting a logistic model to daily-reported case numbers, up to the first and second epidemic peaks. We estimated the basic and effective (second wave) reproduction numbers across countries. Next, we used a random forest algorithm to study the association between the growth rate of the second wave and NPIs as well as pre-existing country-specific characteristics. Lastly, we compared the growth rate of the first and second waves of COVID-19. The top three factors associated with the growth of the second wave were body mass index, the number of days that the government sets restrictions on requiring facial coverings outside the home at all times, and restrictions on gatherings of 10 people or less. Artificial intelligence techniques can help scholars as well as decision and policy-makers estimate the effectiveness of public health policies, and implement "smart" interventions, which are as efficacious as stringent ones.
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Affiliation(s)
| | - Nicola Luigi Bragazzi
- Africa-Canada Artificial Intelligence and Data Innovation Consortium, Department of Mathematics and Statistics, York University, Toronto, ON, M3J 1P3, Canada
| | - Jianhong Wu
- Africa-Canada Artificial Intelligence and Data Innovation Consortium, Department of Mathematics and Statistics, York University, Toronto, ON, M3J 1P3, Canada
| | - Bruce Mellado
- School of Physics, Institute for Collider Particle Physics, University of the Witwatersrand, Johannesburg, South Africa
- iThemba LABS, National Research Foundation, Somerset West, South Africa
| | - Jude Dzevela Kong
- Africa-Canada Artificial Intelligence and Data Innovation Consortium, Department of Mathematics and Statistics, York University, Toronto, ON, M3J 1P3, Canada.
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Mendelson M, Venter F, Moshabela M, Gray G, Blumberg L, de Oliveira T, Madhi SA. The political theatre of the UK's travel ban on South Africa. Lancet 2021; 398:2211-2213. [PMID: 34871546 PMCID: PMC8641956 DOI: 10.1016/s0140-6736(21)02752-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 11/20/2022]
Affiliation(s)
- Marc Mendelson
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town 7925, South Africa.
| | - Francois Venter
- Ezintsha, a sub-division of Wits Reproductive Health and HIV Institute, University of Witwatersrand, Johannesburg, South Africa
| | - Mosa Moshabela
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Glenda Gray
- Office of the President, South African Medical Research Council, Tygerberg, South Africa
| | - Lucille Blumberg
- Right to Care, Tshwane, South Africa; Faculty of Health Sciences, University of Stellenbosch, Cape Town, South Africa
| | - Tulio de Oliveira
- Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa; KwaZulu-Natal Research Innovation and Sequencing Platform, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Shabir A Madhi
- African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
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Singh S, McNab C, Olson RM, Bristol N, Nolan C, Bergstrøm E, Bartos M, Mabuchi S, Panjabi R, Karan A, Abdalla SM, Bonk M, Jamieson M, Werner GK, Nordström A, Legido-Quigley H, Phelan A. How an outbreak became a pandemic: a chronological analysis of crucial junctures and international obligations in the early months of the COVID-19 pandemic. Lancet 2021; 398:2109-2124. [PMID: 34762857 PMCID: PMC8575464 DOI: 10.1016/s0140-6736(21)01897-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 08/01/2021] [Accepted: 08/17/2021] [Indexed: 12/11/2022]
Abstract
Understanding the spread of SARS-CoV-2, how and when evidence emerged, and the timing of local, national, regional, and global responses is essential to establish how an outbreak became a pandemic and to prepare for future health threats. With that aim, the Independent Panel for Pandemic Preparedness and Response has developed a chronology of events, actions, and recommendations, from December, 2019, when the first cases of COVID-19 were identified in China, to the end of March, 2020, by which time the outbreak had spread extensively worldwide and had been characterised as a pandemic. Datapoints are based on two literature reviews, WHO documents and correspondence, submissions to the Panel, and an expert verification process. The retrospective analysis of the chronology shows a dedicated initial response by WHO and some national governments, but also aspects of the response that could have been quicker, including outbreak notifications under the International Health Regulations (IHR), presumption and confirmation of human-to-human transmission of SARS-CoV-2, declaration of a Public Health Emergency of International Concern, and, most importantly, the public health response of many national governments. The chronology also shows that some countries, largely those with previous experience with similar outbreaks, reacted quickly, even ahead of WHO alerts, and were more successful in initially containing the virus. Mapping actions against IHR obligations, the chronology shows where efficiency and accountability could be improved at local, national, and international levels to more quickly alert and contain health threats in the future. In particular, these improvements include necessary reforms to international law and governance for pandemic preparedness and response, including the IHR and a potential framework convention on pandemic preparedness and response.
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Affiliation(s)
- Sudhvir Singh
- The Independent Panel for Pandemic Preparedness and Response, Geneva, Switzerland; Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
| | - Christine McNab
- The Independent Panel for Pandemic Preparedness and Response, Geneva, Switzerland
| | - Rose McKeon Olson
- Brigham and Women's Hospital, Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Nellie Bristol
- The Independent Panel for Pandemic Preparedness and Response, Geneva, Switzerland
| | - Cody Nolan
- Brigham and Women's Hospital, Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Elin Bergstrøm
- The Independent Panel for Pandemic Preparedness and Response, Geneva, Switzerland
| | - Michael Bartos
- The Independent Panel for Pandemic Preparedness and Response, Geneva, Switzerland; School of Sociology, Australian National University, Canberra, ACT, Australia
| | - Shunsuke Mabuchi
- The Independent Panel for Pandemic Preparedness and Response, Geneva, Switzerland
| | - Raj Panjabi
- The Independent Panel for Pandemic Preparedness and Response, Geneva, Switzerland
| | - Abraar Karan
- Brigham and Women's Hospital, Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Salma M Abdalla
- The Independent Panel for Pandemic Preparedness and Response, Geneva, Switzerland; Boston University School of Public Health, Boston, MA, USA
| | - Mathias Bonk
- The Independent Panel for Pandemic Preparedness and Response, Geneva, Switzerland
| | - Margaret Jamieson
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - George K Werner
- The Independent Panel for Pandemic Preparedness and Response, Geneva, Switzerland
| | - Anders Nordström
- The Independent Panel for Pandemic Preparedness and Response, Geneva, Switzerland
| | - Helena Legido-Quigley
- The Independent Panel for Pandemic Preparedness and Response, Geneva, Switzerland; London School of Hygiene & Tropical Medicine, London, UK; Saw Swee Hock School of Public Health, Singapore
| | - Alexandra Phelan
- The Independent Panel for Pandemic Preparedness and Response, Geneva, Switzerland; Center for Global Health Science & Security, Georgetown University, Washington, DC, USA
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Effects of COVID-19 on Variations of Taxpayers in Tourism-Reliant Regions: The Case of the Mexican Caribbean. JOURNAL OF RISK AND FINANCIAL MANAGEMENT 2021. [DOI: 10.3390/jrfm14120578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Given the tourism industry’s risk and vulnerability to pandemics and the need to better understand the impacts on tourism destinations, this research assesses the effect of the COVID-19 outbreak on the variation of taxpayer units in the Mexican Caribbean region, which includes some of the major sun-and-sand beach destinations in Latin America. Using monthly data of registered taxpayer entities at the state and national levels as the analysis variable, probability distributions and definite integrals are employed to determine variations of the year following the lockdown, compared with previous years’ data. Results indicate that despite the government’s measures to restrict businesses’ operations and a reduction in tourism activities, registered taxpayers at the regional level did not decrease for most of 2020. Further, as business activities and tourism recovered, taxpayer units increased at the end of 2020 and beginning of 2021. Surprisingly, such a pattern was not observed at the national level, which yielded no statistically significant variations. A discussion of factors influencing the resilience of the tourism region in the study (e.g., outbound markets’ geographic proximity, absence of travel restrictions, closure of competing destinations) and implications for public finances are presented.
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Kamat A, Sah A. Early Detection of COVID-19 Waves From Cases in a Neighboring Country With an Open Border. Front Public Health 2021; 9:739738. [PMID: 34778174 PMCID: PMC8585937 DOI: 10.3389/fpubh.2021.739738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 09/30/2021] [Indexed: 12/28/2022] Open
Abstract
Border closure or travel restriction is a critical issue as closing the border early can badly affect the economy of the country, whereas substantial delay can put human lives at stake. While many papers discuss closing the border early in the pandemic, the question of when to close the border has not been addressed well. We have tried to estimate a date of closing the border by taking the reference of a neighboring country with a high correlation in Covid-19 incidence. Here we have used non-linear methods to probe the landscape of correlation between temporal COVID-19 incidences and deaths. We have tested our method on two neighboring countries, Nepal and India, with open borders, where closing the borders are among the top priorities to reduce the spread and spill-out of variants. We have selected these countries as they have close connectivity and intertwined socio-economic network with thousands of people crossing the border every day. We found the distance correlation for COVID-19 incidence between these countries to be statistically significant (p < 0.001) and there is a lag of 6 days for maximum correlation. In addition, we analyzed the correlation for each wave and found the distance correlation for the first phase is 0.8145 (p < 0.001) with a lag of 2 days, and the distance correlation for the second wave is 0.9685 (p < 0.001) without any lag. This study can be a critical planning tool for policymakers and public health practitioners to make an informed decision on border closure in the early days as it is critically associated with the legal and diplomatic agreements and regulations between two countries.
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Affiliation(s)
- Anil Kamat
- Department of Mechanical, Aerospace and Nuclear Engineering, Rensselaer Polytechnic Institute, Troy, NY, United States
| | - Amrita Sah
- Nepalgunj Medical College, Nepalgunj, Nepal
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Jit M, Ananthakrishnan A, McKee M, Wouters OJ, Beutels P, Teerawattananon Y. Multi-country collaboration in responding to global infectious disease threats: lessons for Europe from the COVID-19 pandemic. THE LANCET REGIONAL HEALTH. EUROPE 2021; 9:100221. [PMID: 34642675 PMCID: PMC8495250 DOI: 10.1016/j.lanepe.2021.100221] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/29/2022]
Abstract
Since 2005, the world has faced several public health emergencies of international concern arising from infectious disease outbreaks. Of these, the COVID-19 pandemic has had by far the greatest health and economic consequences. During these emergencies, responses taken by one country often have an impact on other countries. The implication is that coordination between countries is likely to achieve better outcomes, individually and collectively, than each country independently pursuing its own self-interest. During the COVID-19 pandemic, gaps in multilateral cooperation on research and information sharing, vaccine development and deployment, and travel policies have hampered the speed and equity of global recovery. In this Health Policy article, we explore how multilateral collaboration between countries is crucial to successful responses to public health emergencies linked to infectious disease outbreaks. Responding to future global infectious disease threats and other health emergencies will require the creation of stronger mechanisms for multilateral collaboration before they arise. A change to the governance of multilateral institutions is a logical next step, with a focus on providing equal ownership and leadership opportunities to all member countries. Europe can be an example and advocate for stronger and better governed multilateral institutions.
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Affiliation(s)
- Mark Jit
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
- School of Public Health, University of Hong Kong, Hong Kong SAR, China
| | - Aparna Ananthakrishnan
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Thailand
| | - Martin McKee
- Department of Health Services and Policy, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Olivier J. Wouters
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Philippe Beutels
- Centre for Health Economic Research and Modelling Infectious Diseases, Vaccine & Infectious Diseases Institute, University of Antwerp, Antwerp, Belgium
- School of Public health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Yot Teerawattananon
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Thailand
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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A Review of Research on Tourism Industry, Economic Crisis and Mitigation Process of the Loss: Analysis on Pre, During and Post Pandemic Situation. SUSTAINABILITY 2021. [DOI: 10.3390/su131810314] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Throughout time, the global tourism industry and economy have been significantly affected by disasters and crises. At present, COVID-19 represents one of these disasters as it has been causing a serious economic downturn with huge implications in tourism. In this review paper, we have analysed more than 100 papers regarding the effect and consequences of a pandemic on tourism and related industries, the economic situation in countries and areas, and mitigation of the loss incurred due to pandemic situations. The article (1) is based on past research on tourism and economy, (2) examines the effects of a pandemic on listed sectors and mitigation processes, and (3) suggests future research and approaches to help progress the field. We have gathered and categorised the literature reviews into several parts. In addition, we have listed the name of authors, journal names, books, websites, and relevant data.
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Lee K, Grépin KA, Worsnop C, Marion S, Piper J, Song M. Managing borders during public health emergencies of international concern: a proposed typology of cross-border health measures. Global Health 2021; 17:62. [PMID: 34154597 PMCID: PMC8215479 DOI: 10.1186/s12992-021-00709-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/12/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The near universal adoption of cross-border health measures during the COVID-19 pandemic worldwide has prompted significant debate about their effectiveness and compliance with international law. The number of measures used, and the range of measures applied, have far exceeded previous public health emergencies of international concern. However, efforts to advance research, policy and practice to support their effective use has been hindered by a lack of clear and consistent definition. RESULTS Based on a review of existing datasets for cross-border health measures, such as the Oxford Coronavirus Government Response Tracker and World Health Organization Public Health and Social Measures, along with analysis of secondary and grey literature, we propose six categories to define measures more clearly and consistently - policy goal, type of movement (travel and trade), adopted by public or private sector, level of jurisdiction applied, stage of journey, and degree of restrictiveness. These categories are then brought together into a proposed typology that can support research with generalizable findings and comparative analyses across jurisdictions. Addressing the current gaps in evidence about travel measures, including how different jurisdictions apply such measures with varying effects, in turn, enhances the potential for evidence-informed decision-making based on fuller understanding of policy trade-offs and externalities. Finally, through the adoption of standardized terminology and creation of an agreed evidentiary base recognized across jurisdictions, the typology can support efforts to strengthen coordinated global responses to outbreaks and inform future efforts to revise the WHO International Health Regulations (2005). CONCLUSIONS The widespread use of cross-border health measures during the COVID-19 pandemic has prompted significant reflection on available evidence, previous practice and existing legal frameworks. The typology put forth in this paper aims to provide a starting point for strengthening research, policy and practice.
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Affiliation(s)
- Kelley Lee
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall, 8888 University Drive, Burnaby, BC V5A 1S6 Canada
| | - Karen A. Grépin
- School of Public Health, University of Hong Kong, UB/F, Patrick Manson Building, 7 Sassoon Road, Pokfulam, Hong Kong
| | - Catherine Worsnop
- School of Public Policy, University of Maryland, 2101 Van Munching Hall, College Park, MD 20742 USA
| | - Summer Marion
- School of Public Policy, University of Maryland, 2101 Van Munching Hall, College Park, MD 20742 USA
- Department of Political Science, Northeastern University, 360 Huntington Ave, Boston, MA 02115 USA
| | - Julianne Piper
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall, 8888 University Drive, Burnaby, BC V5A 1S6 Canada
| | - Mingqi Song
- School of Public Health, University of Hong Kong, UB/F, Patrick Manson Building, 7 Sassoon Road, Pokfulam, Hong Kong
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