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Kongkamol C, Ingviya T, Chusri S, Surasombatpattana S, Kwanyuang A, Chaichulee S, Sophark I, Seesong C, Sorntavorn T, Detpreechakul T, Phaiboonpornpong P, Krainara K, Sathirapanya P, Sathirapanya C. Integrative Effects between a Bubble and Seal Program and Workers' Compliance to Health Advice on Successful COVID-19 Transmission Control in a Factory in Southern Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16391. [PMID: 36554271 PMCID: PMC9778696 DOI: 10.3390/ijerph192416391] [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: 11/16/2022] [Revised: 11/30/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
Applying health measures to prevent COVID-19 transmission caused disruption of businesses. A practical plan to balance public health and business sustainability during the pandemic was needed. Herein, we describe a "Bubble and Seal" (B&S) program implemented in a frozen seafood factory in southern Thailand. We enrolled 1539 workers who lived in the factory dormitories. First, the workers who had a high fatality risk were triaged by RT-PCR tests, quarantined and treated if they had COVID-19. Newly diagnosed or suspected COVID-19 workers underwent the same practices. The non-quarantined workers were regulated to work and live in their groups without contact across the groups. Workers' personal hygiene and preventive measures were strongly stressed. Between the 6th and 9th weeks of the program, the post-COVID-19 infection status (PCIS) of all participants was evaluated by mass COVID-19 antibody or RT-PCR tests. Finally, 91.8% of the workers showed positive PCIS, which was above the number required for program exit. Although no workers had received a vaccination, there was only one case of severe COVID-19 pneumonia, and no evidence of COVID-19 spreading to the surrounding communities. Implementation of the B&S program and workers' adherence to health advice was the key to this success.
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Affiliation(s)
- Chanon Kongkamol
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Songkhla, Thailand
- Air Pollution and Health Effect Research Center, Prince of Songkla University, Hat Yai 90110, Songkhla, Thailand
| | - Thammasin Ingviya
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Songkhla, Thailand
- Air Pollution and Health Effect Research Center, Prince of Songkla University, Hat Yai 90110, Songkhla, Thailand
| | - Sarunyou Chusri
- Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Songkhla, Thailand
| | - Smonrapat Surasombatpattana
- Department of Pathology, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Songkhla, Thailand
| | - Atichart Kwanyuang
- Department of Biomedical Sciences and Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Songkhla, Thailand
| | - Sitthichok Chaichulee
- Department of Biomedical Sciences and Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Songkhla, Thailand
| | - Intouch Sophark
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Songkhla, Thailand
| | - Chaiwat Seesong
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Songkhla, Thailand
| | - Thanawan Sorntavorn
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Songkhla, Thailand
| | - Tanyawan Detpreechakul
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Songkhla, Thailand
| | - Pindanunant Phaiboonpornpong
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Songkhla, Thailand
| | - Kamol Krainara
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Songkhla, Thailand
| | - Pornchai Sathirapanya
- Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Songkhla, Thailand
| | - Chutarat Sathirapanya
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Songkhla, Thailand
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Disability-adjusted life years (DALYs) due to the direct health impact of COVID-19 in India, 2020. Sci Rep 2022; 12:2454. [PMID: 35165362 PMCID: PMC8844028 DOI: 10.1038/s41598-022-06505-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 01/24/2022] [Indexed: 12/23/2022] Open
Abstract
COVID-19 has affected all countries. Its containment represents a unique challenge for India due to a large population (> 1.38 billion) across a wide range of population densities. Assessment of the COVID-19 disease burden is required to put the disease impact into context and support future pandemic policy development. Here, we present the national-level burden of COVID-19 in India in 2020 that accounts for differences across urban and rural regions and across age groups. Input data were collected from official records or published literature. The proportion of excess COVID-19 deaths was estimated using the Institute for Health Metrics and Evaluation, Washington data. Disability-adjusted life years (DALY) due to COVID-19 were estimated in the Indian population in 2020, comprised of years of life lost (YLL) and years lived with disability (YLD). YLL was estimated by multiplying the number of deaths due to COVID-19 by the residual standard life expectancy at the age of death due to the disease. YLD was calculated as a product of the number of incident cases of COVID-19, disease duration and disability weight. Scenario analyses were conducted to account for excess deaths not recorded in the official data and for reported COVID-19 deaths. The direct impact of COVID-19 in 2020 in India was responsible for 14,100,422 (95% uncertainty interval [UI] 14,030,129–14,213,231) DALYs, consisting of 99.2% (95% UI 98.47–99.64%) YLLs and 0.80% (95% UI 0.36–1.53) YLDs. DALYs were higher in urban (56%; 95% UI 56–57%) than rural areas (44%; 95% UI 43.4–43.6) and in men (64%) than women (36%). In absolute terms, the highest DALYs occurred in the 51–60-year-old age group (28%) but the highest DALYs per 100,000 persons were estimated for the 71–80 years old age group (5481; 95% UI 5464–5500 years). There were 4,815,908 (95% UI 4,760,908–4,924,307) DALYs after considering reported COVID-19 deaths only. The DALY estimations have direct and immediate implications not only for public policy in India, but also internationally given that India represents one sixth of the world’s population.
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Koo JR, Dickens BL, Jin S, Lim JT, Sun Y, Tan KW, Cook AR. Testing strategies to contain COVID-19 in migrant worker dormitories. J Migr Health 2022; 5:100079. [PMID: 35098194 PMCID: PMC8779923 DOI: 10.1016/j.jmh.2022.100079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 01/17/2022] [Accepted: 01/20/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction COVID-19 transmission within overcrowded migrant worker dormitories is an ongoing global issue. Many countries have implemented extensive control measures to prevent the entire migrant worker population from becoming infected. Here, we explore case count outcomes when utilizing lockdown and testing under different testing measures and transmissibility settings. Methods We built a mathematical model which estimates transmission across 10 different blocks with 1000 individuals per block under different parameter combinations and testing conditions over the period of 1 month. We vary parameters including differences in block connectivity, underlying recovered proportions at the time of intervention, case importation rates and testing protocols using either PCR or rapid antigen testing. Results We estimate that a relatively transmissible environment with fortnightly PCR testing at a relatively low initial recovered proportion of 40%, low connectivity where 10% of contacts occurred outside of the infected individuals’ block and a high importation rate of 1100000 per day, results in an average of 39 (95%Interval: 9–121) new COVID-19 cases after one month of observation. Similar results were observed for weekly rapid antigen testing at 33 (9–95) cases. Interpretation Our findings support the need for either fortnightly PCR testing or weekly rapid antigen testing in high population density environments such as migrant worker dormitories. Repeated mass testing is highly effective, preventing localized site outbreaks and reducing the need for site wide lockdowns or other extensive social distancing measures within and outside of dormitories.
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Abstract
The study of epidemics is useful for not only understanding outbreaks and trying to limit their adverse effects, but also because epidemics are related to social phenomena such as government instability, crime, poverty, and inequality. One approach for studying epidemics is to simulate their spread through populations. In this work, we describe an integrated multi-dimensional approach to epidemic simulation, which encompasses: (1) a theoretical framework for simulation and analysis; (2) synthetic population (digital twin) generation; (3) (social contact) network construction methods from synthetic populations, (4) stylized network construction methods; and (5) simulation of the evolution of a virus or disease through a social network. We describe these aspects and end with a short discussion on simulation results that inform public policy.
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Khadadah F, Al-Shammari AA, Alhashemi A, Alhuwail D, Al-Saif B, Alzaid SN, Alahmad B, Bogoch II. The effects of non-pharmaceutical interventions on SARS-CoV-2 transmission in different socioeconomic populations in Kuwait: a modeling study. BMC Public Health 2021; 21:990. [PMID: 34039289 PMCID: PMC8152192 DOI: 10.1186/s12889-021-10984-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 05/05/2021] [Indexed: 12/02/2022] Open
Abstract
Background Aggressive non-pharmaceutical interventions (NPIs) may reduce transmission of SARS-CoV-2. The extent to which these interventions are successful in stopping the spread have not been characterized in countries with distinct socioeconomic groups. We compared the effects of a partial lockdown on disease transmission among Kuwaitis (P1) and non-Kuwaitis (P2) living in Kuwait. Methods We fit a modified metapopulation SEIR transmission model to reported cases stratified by two groups to estimate the impact of a partial lockdown on the effective reproduction number (\documentclass[12pt]{minimal}
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\begin{document}$$ {\mathcal{R}}_e $$\end{document}Re). We estimated the basic reproduction number (\documentclass[12pt]{minimal}
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\begin{document}$$ {\mathcal{R}}_0 $$\end{document}R0) for the transmission in each group and simulated the potential trajectories of an outbreak from the first recorded case of community transmission until 12 days after the partial lockdown. We estimated \documentclass[12pt]{minimal}
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\begin{document}$$ {\mathcal{R}}_e $$\end{document}Re values of both groups before and after the partial curfew, simulated the effect of these values on the epidemic curves and explored a range of cross-transmission scenarios. Results We estimate \documentclass[12pt]{minimal}
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\begin{document}$$ {\mathcal{R}}_e $$\end{document}Re at 1·08 (95% CI: 1·00–1·26) for P1 and 2·36 (2·03–2·71) for P2. On March 22nd, \documentclass[12pt]{minimal}
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\begin{document}$$ {\mathcal{R}}_e $$\end{document}Re for P1 and P2 are estimated at 1·19 (1·04–1·34) and 1·75 (1·26–2·11) respectively. After the partial curfew had taken effect, \documentclass[12pt]{minimal}
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\begin{document}$$ {\mathcal{R}}_e $$\end{document}Re for P1 dropped modestly to 1·05 (0·82–1·26) but almost doubled for P2 to 2·89 (2·30–3·70). Our simulated epidemic trajectories show that the partial curfew measure greatly reduced and delayed the height of the peak in P1, yet significantly elevated and hastened the peak in P2. Modest cross-transmission between P1 and P2 greatly elevated the height of the peak in P1 and brought it forward in time closer to the peak of P2. Conclusion Our results indicate and quantify how the same lockdown intervention can accentuate disease transmission in some subpopulations while potentially controlling it in others. Any such control may further become compromised in the presence of cross-transmission between subpopulations. Future interventions and policies need to be sensitive to socioeconomic and health disparities. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10984-6.
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Affiliation(s)
- Fatima Khadadah
- Department of Medicine, University of Toronto, Toronto, ON, Canada. .,Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 610 University Ave, 700U 6W458, Toronto, ON, M5G 2M9, Canada.
| | - Abdullah A Al-Shammari
- Department of Mathematics, Faculty of Sciences, Kuwait University, Khaldiya, Kuwait. .,Dasman Diabetes Institute, Dasman, Kuwait.
| | - Ahmad Alhashemi
- Department of Medicine, Adan Hospital, Ministry of Health, Al-Ahmadi, Kuwait
| | - Dari Alhuwail
- Dasman Diabetes Institute, Dasman, Kuwait.,Department of Information Science, College of Life Sciences, Kuwait University, Sabah Al-Salem University City, Sabah Al-Salem, Kuwait
| | - Bader Al-Saif
- Department of History, College of Arts, Kuwait University, Sabah Al-Salem University City, Sabah Al-Salem, Kuwait.,Carnegie Middle East Center, Beirut, Lebanon
| | - Saud N Alzaid
- Department of Surgery, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
| | - Barrak Alahmad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Isaac I Bogoch
- Department of Medicine, University of Toronto, Toronto, ON, Canada
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Raju E, Dutta A, Ayeb-Karlsson S. COVID-19 in India: Who are we leaving behind? PROGRESS IN DISASTER SCIENCE 2021; 10:100163. [PMID: 34095809 PMCID: PMC7989097 DOI: 10.1016/j.pdisas.2021.100163] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/18/2021] [Accepted: 03/23/2021] [Indexed: 05/29/2023]
Abstract
The COVID-19 pandemic has uncovered and intensified existing societal inequalities. People on the move and residents of urban slums and informal settlements are among some of the most affected groups in the Global South. Given the current living conditions of migrants, the WHO guidelines on how to prevent COVID-19 (such as handwashing, physical distancing and working from home) are challenging to nearly impossible in informal settlements. We use the case of India to highlight the challenges of migrants and urban slum dwellers during the COVID-19 response, and to provide human rights-based recommendations for immediate action to safeguard these vulnerable populations.
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Affiliation(s)
- Emmanuel Raju
- Global Health Section, Department of Public Health & Copenhagen Centre for Disaster Research, University of Copenhagen, CSS, Øster Farimagsgade 5, 1014 København K, Denmark
- African Centre for Disaster Studies, North-West University, Private Bag X6001, Potchefstroom, North West Province 2520, South Africa
| | - Anwesha Dutta
- Christian Michelsen Institute (CMI), P.O.Box 6033, N-5892 Bergen, Norway
| | - Sonja Ayeb-Karlsson
- University of Sussex, School of Global Studies, Arts Road Building C, Falmer Brighton, BN1 9SJ, UK
- United Nations University - Institute for Environment and Human Security, UN Campus, Platz der Vereinten Nationen 1, D-53113 Bonn, Germany
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Kamalipour H, Peimani N. Informal urbanism in the state of uncertainty: forms of informality and urban health emergencies. URBAN DESIGN INTERNATIONAL 2021; 26:122-134. [PMCID: PMC7720475 DOI: 10.1057/s41289-020-00145-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/09/2020] [Indexed: 06/13/2023]
Abstract
Forms of informality—ranging from informal settlements to street vending and informal transport—have become integral, yet not necessarily limited to how cities of the global South work. Our aim in this paper is to explore the dynamics of informal urbanism in the face of the COVID-19 pandemic and the extent to which forms of informality can adapt in the state of uncertainty. This paper lies in the intersections of informal urbanism and urban design in relation to public health emergencies. This is an exploratory paper in nature, structured in three main sections to focus on the implications of the Coronavirus pandemic on informal settlements, street vending, and informal transport, respectively. We point to how different forms of informality work across cities and conclude by outlining some key considerations and discussing the role of urban design in addressing the capacities and challenges of informal urbanism in the state of uncertainty facing public health emergencies such as the Coronavirus pandemic.
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Affiliation(s)
- Hesam Kamalipour
- School of Geography and Planning, Cardiff University, Room 2.98 Glamorgan Building South, King Edward VII Avenue, Cardiff, CF10 3WA UK
| | - Nastaran Peimani
- Welsh School of Architecture, Cardiff University, Room 1.33 Bute Building, King Edward VII Avenue, Cardiff, CF10 3NB UK
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Talekar A, Shriram S, Vaidhiyan N, Aggarwal G, Chen J, Venkatramanan S, Wang L, Adiga A, Sadilek A, Tendulkar A, Marathe M, Sundaresan R, Tambe M. Cohorting to isolate asymptomatic spreaders: An agent-based simulation study on the Mumbai Suburban Railway. ARXIV 2020:arXiv:2012.12839v2. [PMID: 33398245 PMCID: PMC7781320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Revised: 12/24/2020] [Indexed: 11/06/2022]
Abstract
The Mumbai Suburban Railways, locals, are a key transit infrastructure of the city and is crucial for resuming normal economic activity. Due to high density during transit, the potential risk of disease transmission is high, and the government has taken a wait and see approach to resume normal operations. To reduce disease transmission, policymakers can enforce reduced crowding and mandate wearing of masks. Cohorting - forming groups of travelers that always travel together, is an additional policy to reduce disease transmission on locals without severe restrictions. Cohorting allows us to: (i) form traveler bubbles, thereby decreasing the number of distinct interactions over time; (ii) potentially quarantine an entire cohort if a single case is detected, making contact tracing more efficient, and (iii) target cohorts for testing and early detection of symptomatic as well as asymptomatic cases. Studying impact of cohorts using compartmental models is challenging because of the ensuing representational complexity. Agent-based models provide a natural way to represent cohorts along with the representation of the cohort members with the larger social network. This paper describes a novel multi-scale agent-based model to study the impact of cohorting strategies on COVID-19 dynamics in Mumbai. We achieve this by modeling the Mumbai urban region using a detailed agent-based model comprising of 12.4 million agents. Individual cohorts and their inter-cohort interactions as they travel on locals are modeled using local mean field approximations. The resulting multi-scale model in conjunction with a detailed disease transmission and intervention simulator is used to assess various cohorting strategies. The results provide a quantitative trade-off between cohort size and its impact on disease dynamics and well being. The results show that cohorts can provide significant benefit in terms of reduced transmission without significantly impacting ridership and or economic & social activity.
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Wilkinson A. Local response in health emergencies: key considerations for COVID-19 in informal urban settlements. ENVIRONMENT AND URBANIZATION 2020; 32:503-522. [PMID: 36438604 PMCID: PMC7613852 DOI: 10.1177/0956247820922843] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
This paper highlights the major challenges and considerations for addressing COVID-19 in informal settlements. It discusses what is known about vulnerabilities and how to support local protective action. There is heightened concern about informal urban settlements because of the combination of population density and inadequate access to water and sanitation, which makes standard advice about social distancing and washing hands implausible. There are further challenges to do with the lack of reliable data and the social, political and economic contexts in each setting that will influence vulnerability and possibilities for action. The potential health impacts of COVID-19 are immense in informal settlements, but if control measures are poorly executed these could also have deep negative impacts. Public health interventions must be balanced with social and economic interventions, especially in relation to the informal economy upon which many poor urban residents depend. Local residents, leaders and community-based groups must be engaged and resourced to develop locally appropriate control strategies, in partnership with local governments and authorities. Historically, informal settlements and their residents have been stigmatized, blamed, and subjected to rules and regulations that are unaffordable or unfeasible to adhere to. Responses to COVID-19 should not repeat these mistakes. Priorities for enabling effective control measures include: collaborating with local residents who have unsurpassed knowledge of relevant spatial and social infrastructures, strengthening coordination with local governments, and investing in improved data for monitoring the response in informal settlements.
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Wang L, Chen J, Marathe A. A Framework for Discovering Health Disparities among Cohorts in an Influenza Epidemic. WORLD WIDE WEB 2019; 22:2997-3020. [PMID: 31777450 PMCID: PMC6880941 DOI: 10.1007/s11280-018-0608-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Infectious diseases such as Influenza and Ebola pose a serious threat to everyone but certain demographics and cohorts face a higher risk of infection than others. This research provides a computational framework for studying health disparities among cohorts based on individual level features, such as age, gender, income, etc. We apply this framework to find health disparities among subpopulations in an influenza epidemic and evaluate vaccination prioritization strategies to achieve specific objectives. We explore the heterogeneities in individuals' demographic and socioeconomic attributes as the potential cause of health disparities. An agent-based model is used to simulate an influenza epidemic over a synthetic social contact network of the Montgomery County in Southwest Virginia to identify infected cases which are then labeled with a specific clinical outcome by using a predefined probability distribution based on age and risk level. We divide the population into age and income based cohorts and measure the direct and indirect economic impact of vaccination for each cohort. Simulation-based results find strong health disparities across age and income groups. Various vaccine distribution strategies are considered and outcomes are measured through metrics such as death count, total number of infections, net return per capita, net return per dollar spent and net return per vaccinated person. The results, framework, and methodology developed here can assist public health policy makers in efficiently allocating limited pharmaceutical resources.
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Affiliation(s)
- Lijing Wang
- Department of Computer Science, Virginia Tech, Network Dynamics and Simulation Science Laboratory, Biocomplexity Institute of Virginia Tech, Blacksburg, VA 24061 USA
| | - Jiangzhuo Chen
- Network Dynamics and Simulation Science Laboratory, Biocomplexity Institute of Virginia Tech, Blacksburg, VA 24061, USA
| | - Achla Marathe
- Department of Agricultural and Applied Economics, Virginia Tech, Network Dynamics and Simulation Science Laboratory, Biocomplexity Institute of Virginia Tech, Blacksburg, VA 24061 USA
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11
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Singh M, Sarkhel P, Kang GJ, Marathe A, Boyle K, Murray-Tuite P, Abbas KM, Swarup S. Impact of demographic disparities in social distancing and vaccination on influenza epidemics in urban and rural regions of the United States. BMC Infect Dis 2019; 19:221. [PMID: 30832594 PMCID: PMC6399923 DOI: 10.1186/s12879-019-3703-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 01/09/2019] [Indexed: 01/29/2023] Open
Abstract
Background Self-protective behaviors of social distancing and vaccination uptake vary by demographics and affect the transmission dynamics of influenza in the United States. By incorporating the socio-behavioral differences in social distancing and vaccination uptake into mathematical models of influenza transmission dynamics, we can improve our estimates of epidemic outcomes. In this study we analyze the impact of demographic disparities in social distancing and vaccination on influenza epidemics in urban and rural regions of the United States. Methods We conducted a survey of a nationally representative sample of US adults to collect data on their self-protective behaviors, including social distancing and vaccination to protect themselves from influenza infection. We incorporated this data in an agent-based model to simulate the transmission dynamics of influenza in the urban region of Miami Dade county in Florida and the rural region of Montgomery county in Virginia. Results We compare epidemic scenarios wherein the social distancing and vaccination behaviors are uniform versus non-uniform across different demographic subpopulations. We infer that a uniform compliance of social distancing and vaccination uptake among different demographic subpopulations underestimates the severity of the epidemic in comparison to differentiated compliance among different demographic subpopulations. This result holds for both urban and rural regions. Conclusions By taking into account the behavioral differences in social distancing and vaccination uptake among different demographic subpopulations in analysis of influenza epidemics, we provide improved estimates of epidemic outcomes that can assist in improved public health interventions for prevention and control of influenza. Electronic supplementary material The online version of this article (10.1186/s12879-019-3703-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Meghendra Singh
- Network Dynamics and Simulation Science Laboratory, Biocomplexity Institute of Virginia Tech, Blacksburg, 24060, Virginia, USA
| | - Prasenjit Sarkhel
- Department of Economics, University of Kalyani, Nadia, 741235, West Bengal, India
| | - Gloria J Kang
- Network Dynamics and Simulation Science Laboratory, Biocomplexity Institute of Virginia Tech, Blacksburg, 24060, Virginia, USA.,Department of Population Health Sciences, Virginia Tech, Blacksburg, 24060, Virginia, USA
| | - Achla Marathe
- Biocomplexity Institute & Initiative, University of Virginia, Charlottesville, 22908, Virginia, USA. .,Department of Public Health Sciences, University of Virginia, Charlottesville, 22908, Virginia, USA.
| | - Kevin Boyle
- Department of Agricultural and Applied Economics, Virginia Tech, Blacksburg, 24060, Virginia, USA
| | - Pamela Murray-Tuite
- Department of Civil Engineering, Clemson University, Clemson, 29634, South Carolina, USA
| | - Kaja M Abbas
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, WC1E7HT, UK
| | - Samarth Swarup
- Biocomplexity Institute & Initiative, University of Virginia, Charlottesville, 22908, Virginia, USA
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12
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Chen J, Marathe A, Marathe M. Feedback Between Behavioral Adaptations and Disease Dynamics. Sci Rep 2018; 8:12452. [PMID: 30127447 PMCID: PMC6102227 DOI: 10.1038/s41598-018-30471-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 07/27/2018] [Indexed: 11/26/2022] Open
Abstract
We study the feedback processes between individual behavior, disease prevalence, interventions and social networks during an influenza pandemic when a limited stockpile of antivirals is shared between the private and the public sectors. An economic model that uses prevalence-elastic demand for interventions is combined with a detailed social network and a disease propagation model to understand the feedback mechanism between epidemic dynamics, market behavior, individual perceptions, and the social network. An urban and a rural region are simulated to assess the robustness of results. Results show that an optimal split between the private and public sectors can be reached to contain the disease but the accessibility of antivirals from the private sector is skewed towards the richest income quartile. Also, larger allocations to the private sector result in wastage where individuals who do not need it are able to purchase it but who need it cannot afford it. Disease prevalence increases with household size and total contact time but not by degree in the social network, whereas wastage of antivirals decreases with degree and contact time. The best utilization of drugs is achieved when individuals with high contact time use them, who tend to be the school-aged children of large families.
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Affiliation(s)
- Jiangzhuo Chen
- Network Dynamics and Simulation Science Laboratory, Virginia Tech, Blacksburg, VA, 24061, USA.
| | - Achla Marathe
- Network Dynamics and Simulation Science Laboratory, Virginia Tech, Blacksburg, VA, 24061, USA
- Department of Agricultural and Applied Economics, Virginia Tech, Blacksburg, VA, 24061, USA
| | - Madhav Marathe
- Network Dynamics and Simulation Science Laboratory, Virginia Tech, Blacksburg, VA, 24061, USA
- Department of Computer Science, Virginia Tech, Blacksburg, VA, 24061, USA
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Adiga A, Chu S, Eubank S, Kuhlman CJ, Lewis B, Marathe A, Marathe M, Nordberg EK, Swarup S, Vullikanti A, Wilson ML. Disparities in spread and control of influenza in slums of Delhi: findings from an agent-based modelling study. BMJ Open 2018; 8:e017353. [PMID: 29358419 PMCID: PMC5780711 DOI: 10.1136/bmjopen-2017-017353] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES This research studies the role of slums in the spread and control of infectious diseases in the National Capital Territory of India, Delhi, using detailed social contact networks of its residents. METHODS We use an agent-based model to study the spread of influenza in Delhi through person-to-person contact. Two different networks are used: one in which slum and non-slum regions are treated the same, and the other in which 298 slum zones are identified. In the second network, slum-specific demographics and activities are assigned to the individuals whose homes reside inside these zones. The main effects of integrating slums are that the network has more home-related contacts due to larger family sizes and more outside contacts due to more daily activities outside home. Various vaccination and social distancing interventions are applied to control the spread of influenza. RESULTS Simulation-based results show that when slum attributes are ignored, the effectiveness of vaccination can be overestimated by 30%-55%, in terms of reducing the peak number of infections and the size of the epidemic, and in delaying the time to peak infection. The slum population sustains greater infection rates under all intervention scenarios in the network that treats slums differently. Vaccination strategy performs better than social distancing strategies in slums. CONCLUSIONS Unique characteristics of slums play a significant role in the spread of infectious diseases. Modelling slums and estimating their impact on epidemics will help policy makers and regulators more accurately prioritise allocation of scarce medical resources and implement public health policies.
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Affiliation(s)
- Abhijin Adiga
- Network Dynamics and Simulation Sciences Laboratory, Biocomplexity Institute, Virginia Tech, Blacksburg, Virginia, USA
| | - Shuyu Chu
- Network Dynamics and Simulation Sciences Laboratory, Biocomplexity Institute, Virginia Tech, Blacksburg, Virginia, USA
| | - Stephen Eubank
- Network Dynamics and Simulation Sciences Laboratory, Biocomplexity Institute, Virginia Tech, Blacksburg, Virginia, USA
| | - Christopher J Kuhlman
- Network Dynamics and Simulation Sciences Laboratory, Biocomplexity Institute, Virginia Tech, Blacksburg, Virginia, USA
| | - Bryan Lewis
- Network Dynamics and Simulation Sciences Laboratory, Biocomplexity Institute, Virginia Tech, Blacksburg, Virginia, USA
| | - Achla Marathe
- Network Dynamics and Simulation Sciences Laboratory, Biocomplexity Institute, Virginia Tech, Blacksburg, Virginia, USA
| | - Madhav Marathe
- Network Dynamics and Simulation Sciences Laboratory, Biocomplexity Institute, Virginia Tech, Blacksburg, Virginia, USA
| | - Eric K Nordberg
- Network Dynamics and Simulation Sciences Laboratory, Biocomplexity Institute, Virginia Tech, Blacksburg, Virginia, USA
| | - Samarth Swarup
- Network Dynamics and Simulation Sciences Laboratory, Biocomplexity Institute, Virginia Tech, Blacksburg, Virginia, USA
| | - Anil Vullikanti
- Network Dynamics and Simulation Sciences Laboratory, Biocomplexity Institute, Virginia Tech, Blacksburg, Virginia, USA
| | - Mandy L Wilson
- Network Dynamics and Simulation Sciences Laboratory, Biocomplexity Institute, Virginia Tech, Blacksburg, Virginia, USA
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14
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Brownstein JS, Chu S, Marathe A, Marathe MV, Nguyen AT, Paolotti D, Perra N, Perrotta D, Santillana M, Swarup S, Tizzoni M, Vespignani A, Vullikanti AKS, Wilson ML, Zhang Q. Combining Participatory Influenza Surveillance with Modeling and Forecasting: Three Alternative Approaches. JMIR Public Health Surveill 2017; 3:e83. [PMID: 29092812 PMCID: PMC5688248 DOI: 10.2196/publichealth.7344] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 04/06/2017] [Accepted: 10/09/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Influenza outbreaks affect millions of people every year and its surveillance is usually carried out in developed countries through a network of sentinel doctors who report the weekly number of Influenza-like Illness cases observed among the visited patients. Monitoring and forecasting the evolution of these outbreaks supports decision makers in designing effective interventions and allocating resources to mitigate their impact. OBJECTIVE Describe the existing participatory surveillance approaches that have been used for modeling and forecasting of the seasonal influenza epidemic, and how they can help strengthen real-time epidemic science and provide a more rigorous understanding of epidemic conditions. METHODS We describe three different participatory surveillance systems, WISDM (Widely Internet Sourced Distributed Monitoring), Influenzanet and Flu Near You (FNY), and show how modeling and simulation can be or has been combined with participatory disease surveillance to: i) measure the non-response bias in a participatory surveillance sample using WISDM; and ii) nowcast and forecast influenza activity in different parts of the world (using Influenzanet and Flu Near You). RESULTS WISDM-based results measure the participatory and sample bias for three epidemic metrics i.e. attack rate, peak infection rate, and time-to-peak, and find the participatory bias to be the largest component of the total bias. The Influenzanet platform shows that digital participatory surveillance data combined with a realistic data-driven epidemiological model can provide both short-term and long-term forecasts of epidemic intensities, and the ground truth data lie within the 95 percent confidence intervals for most weeks. The statistical accuracy of the ensemble forecasts increase as the season progresses. The Flu Near You platform shows that participatory surveillance data provide accurate short-term flu activity forecasts and influenza activity predictions. The correlation of the HealthMap Flu Trends estimates with the observed CDC ILI rates is 0.99 for 2013-2015. Additional data sources lead to an error reduction of about 40% when compared to the estimates of the model that only incorporates CDC historical information. CONCLUSIONS While the advantages of participatory surveillance, compared to traditional surveillance, include its timeliness, lower costs, and broader reach, it is limited by a lack of control over the characteristics of the population sample. Modeling and simulation can help overcome this limitation as well as provide real-time and long-term forecasting of influenza activity in data-poor parts of the world.
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Affiliation(s)
- John S Brownstein
- Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, United States.,Computational Epidemiology Group, Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
| | - Shuyu Chu
- Network Dynamics and Simulation Science Laboratory, Biocomplexity Institute, Virginia Tech, Blacksburg, VA, United States
| | - Achla Marathe
- Network Dynamics and Simulation Science Laboratory, Biocomplexity Institute, Virginia Tech, Blacksburg, VA, United States
| | - Madhav V Marathe
- Network Dynamics and Simulation Science Laboratory, Biocomplexity Institute, Virginia Tech, Blacksburg, VA, United States
| | - Andre T Nguyen
- Computational Epidemiology Group, Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, United States.,Booz Allen Hamilton, Boston, MA, United States
| | - Daniela Paolotti
- Computational Epidemiology Laboratory, Institute for Scientific Interchange, Turin, Italy
| | - Nicola Perra
- Centre for Business Networks Analysis, University of Greenwich, London, United Kingdom
| | - Daniela Perrotta
- Computational Epidemiology Laboratory, Institute for Scientific Interchange, Turin, Italy
| | - Mauricio Santillana
- Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, United States.,Computational Epidemiology Group, Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
| | - Samarth Swarup
- Network Dynamics and Simulation Science Laboratory, Biocomplexity Institute, Virginia Tech, Blacksburg, VA, United States
| | - Michele Tizzoni
- Computational Epidemiology Laboratory, Institute for Scientific Interchange, Turin, Italy
| | - Alessandro Vespignani
- Laboratory for the Modeling of Biological and Socio-technical Systems, Northeastern University, Boston, MA, United States
| | - Anil Kumar S Vullikanti
- Network Dynamics and Simulation Science Laboratory, Biocomplexity Institute, Virginia Tech, Blacksburg, VA, United States
| | - Mandy L Wilson
- Network Dynamics and Simulation Science Laboratory, Biocomplexity Institute, Virginia Tech, Blacksburg, VA, United States
| | - Qian Zhang
- Laboratory for the Modeling of Biological and Socio-technical Systems, Northeastern University, Boston, MA, United States
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