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Al-Dorzi HM, Alsafwani ZA, Alsalahi E, Aljulayfi AS, Alshaer R, Alanazi S, Aldossari MA, Alsahoo DA, Khan R. Patients with influenza admitted to a tertiary-care hospital in Riyadh between 2018 and 2022: characteristics, outcomes and factors associated with ICU admission and mortality. BMC Pulm Med 2024; 24:464. [PMID: 39300448 DOI: 10.1186/s12890-024-03281-6] [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: 04/01/2024] [Accepted: 09/10/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND Influenza is a common cause of hospital admissions globally with regional variations in epidemiology and clinical profile. We evaluated the characteristics and outcomes of patients with influenza admitted to a tertiary-care center in Riyadh, Saudi Arabia. METHODS This was a retrospective cohort of adult patients admitted with polymerase chain reaction-confirmed influenza to King Abdulaziz Medical City-Riyadh between January 1, 2018, and May 31, 2022. We compared patients who required intensive care unit (ICU) admission to those who did not and performed multivariable logistic regression to assess the predictors of ICU admission and hospital mortality. RESULTS During the study period, 675 adult patients were hospitalized with influenza (median age 68.0 years, females 53.8%, hypertension 59.9%, diabetes 55.1%, and chronic respiratory disease 31.1%). Most admissions (83.0%) were in the colder months (October to March) in Riyadh with inter-seasonal cases even in the summertime (June to August). Influenza A was responsible for 79.0% of cases, with H3N2 and H1N1 subtypes commonly circulating in the study period. Respiratory viral coinfection occurred in 12 patients (1.8%) and bacterial coinfection in 42 patients (17.4%). 151 patients (22.4%) required ICU admission, of which 62.3% received vasopressors and 48.0% mechanical ventilation. Risk factors for ICU admission were younger age, hypertension, bilateral lung infiltrates on chest X-ray, and Pneumonia Severity Index. The overall hospital mortality was 7.4% (22.5% for ICU patients, p < 0.0001). Mortality was 45.0% in patients with bacterial coinfection, 30.9% in those requiring vasopressors, and 29.2% in those who received mechanical ventilation. Female sex (odds ratio [OR], 2.096; 95% confidence interval [CI] 1.070, 4.104), ischemic heart disease (OR, 3.053; 95% CI 1.457, 6.394), immunosuppressed state (OR, 7.102; 95% CI 1.803, 27.975), Pneumonia Severity Index (OR, 1.029; 95% CI, 1.017, 1.041), leukocyte count and serum lactate level (OR, 1.394; 95% CI, 1.163, 1.671) were independently associated with hospital mortality. CONCLUSIONS Influenza followed a seasonal pattern in Saudi Arabia, with H3N2 and H1N1 being the predominant circulating strains during the study period. ICU admission was required for > 20%. Female sex, high Pneumonia Severity Index, ischemic heart disease, and immunosuppressed state were associated with increased mortality.
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Affiliation(s)
- Hasan M Al-Dorzi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Intensive Care Department, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, ICU2, Mail Code 1425, PO Box 22490, Riyadh, 11426, Saudi Arabia.
| | - Zahra A Alsafwani
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Elham Alsalahi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Alaa S Aljulayfi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Roa Alshaer
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Salam Alanazi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Munira A Aldossari
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Deem A Alsahoo
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Raymond Khan
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Intensive Care Department, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, ICU2, Mail Code 1425, PO Box 22490, Riyadh, 11426, Saudi Arabia
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Zhao Y, Xu Y, Yao D, Wu Q, Chen H, Hu X, Huang Y, Zhang X. Changes in Infectious Disease-Specific Health Literacy in the Post-COVID-19 Pandemic Period: Two-Round Cross-Sectional Survey Study. JMIR Public Health Surveill 2024; 10:e52666. [PMID: 39213137 PMCID: PMC11378864 DOI: 10.2196/52666] [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: 09/12/2023] [Revised: 06/22/2024] [Accepted: 06/24/2024] [Indexed: 09/04/2024] Open
Abstract
Background Infectious disease-specific health literacy (IDSHL) is a crucial factor in the development of infectious diseases. It plays a significant role not only in mitigating the resurgence of infectious diseases but also in effectively averting the emergence of novel infections such as COVID-19. During the 3 years of the COVID-19 pandemic, China primarily adopted nonpharmaceutical interventions, advocating for people to avoid crowded places and wear masks to prevent the spread of COVID-19. Consequently, there has been a dearth of research concerning IDSHL and its corresponding focal points for health education. Objective This study aimed to (1) evaluate the changes in IDSHL scores between 2019 (before the COVID-19 pandemic) and 2022 (the postepidemic period of COVID-19) and (2) explore the risk factors affecting IDSHL using a multivariate logistic regression analysis. Methods This study used 2-round cross-sectional surveys, conducted in 2019 and 2022, respectively, in 30 counties in Zhejiang Province, China. Multiple-stage stratified random sampling was used to select households, and a Kish grid was used to identify participants. An identical standardized questionnaire consisting of 12 closed-ended questions was used to measure IDSHL scores before and after the COVID-19 pandemic (2019 and 2022). Standard descriptive statistics, chi-square tests, t tests, and multivariate logistic regression analyses were used to analyze the data. Results The 2-round cross-sectional surveys conducted in 2019 and 2022 yielded, out of 19,366 and 19,221 total questionnaires, 19,257 (99.44% response rate) and 18,857 (98.11% response rate) valid questionnaires, respectively. The correct response rate for the respiratory infectious diseases question "When coughing or sneezing, which of the following is correct?" increased from 29.10% in 2019 to 37.92% in 2022 (χ²1=332.625; P<.001). The correct response rate for the nonrespiratory infectious diseases question "In which of the following ways can hepatitis B be transmitted to others?" decreased from 64.28% to 59.67% (χ²1=86.059; P<.001). In terms of IDSHL scores, a comparison between 2022 and 2019 revealed notable statistical differences in the overall scores (t1=10.829; P<.001) and across the 3 dimensions of knowledge (t1=8.840; P<.001), behavior (t1=16.170; P<.001), and skills (t1=9.115; P<.001). With regard to the questions, all but 4 exhibited statistical differences (P<.001). Multivariate logistic regression analyses indicated that the 2022 year group had a higher likelihood of possessing acquired IDSHL than the 2019 group (odds ratio 1.323, 95% CI 1.264-1.385; P<.001). Conclusions When conducting health education, it is imperative to enhance efforts in nonrespiratory infectious disease health education, as well as respiratory infectious diseases such as COVID-19. Health education interventions should prioritize ethnic minority populations with a poor self-health status and low education.
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Affiliation(s)
- Yusui Zhao
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yue Xu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Dingming Yao
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Qingqing Wu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Heni Chen
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xiujing Hu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yu Huang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xuehai Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
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Urichuk M, Azzi JL, Leitao DJ. The Impact of COVID-19 Restrictions on Hospital Admissions of Common Head and Neck Infections. Laryngoscope 2024; 134:3542-3547. [PMID: 38415842 DOI: 10.1002/lary.31366] [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: 09/15/2023] [Revised: 01/16/2024] [Accepted: 02/08/2024] [Indexed: 02/29/2024]
Abstract
INTRODUCTION Following the emergence of COVID-19, multiple preventative measures were implemented to limit the spread of the disease. This study aims to elucidate the impact of COVID-19 restrictions on hospital admissions of otolaryngology-related infections. MATERIALS AND METHODS A retrospective chart review was conducted to capture all admissions for otolaryngology-related infections in the 2 years pre- and post-COVID-19 at the Health Sciences Centre in Winnipeg, Manitoba. These infections included croup, tracheitis, neck abscess, peritonsillar abscess, otitis media, mastoiditis, sinus infection, orbital infection, pharyngotonsillitis, retro/parapharyngeal abscess, and acute epiglottitis. Demographic information and admission details were collected and analyzed to compare pre- and post-COVID-19 admissions. Further analysis was conducted to compare hospital admissions of patients from rural/remote regions. RESULTS Between March 2018 and March 2022, 253 pediatric patients and 197 adults were admitted for otolaryngology-related infections. Total pediatric admissions decreased post-COVID-19 (154 pre-COVID-19, 99 post-COVID-19; p < 0.001) whereas adult admissions remained stable (107 pre-COVID-19, 90 post-COVID-19; p = 0.25). No significant difference in mean patient age, admission duration, surgical rates or in the proportion of admissions from patients from rural/remote regions was observed in the pediatric or adult cohort when comparing pre-COVID-19 data to post-COVID-19 data. Diagnosis-specific changes in admissions were observed in pediatric croup (40 pre-COVID-19, 15 post-COVID-19; p < 0.001) and in adult orbital infections (30 pre-COVID-19, six post-COVID-19; p < 0.001). CONCLUSION Following the implementation of COVID-19 restrictions, there was a decrease in admissions due to pediatric croup and adult orbital infections with an overall decrease in pediatric Otolaryngology-infection related admissions. LEVEL OF EVIDENCE 3 Laryngoscope, 134:3542-3547, 2024.
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Affiliation(s)
- Matthew Urichuk
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jason Lee Azzi
- Department of Otolaryngology - Head and Neck Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Darren J Leitao
- Department of Otolaryngology - Head and Neck Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
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Soklaridis S, Zaheer R, Scully M, Shier R, Williams B, Dang L, Daniel SJ, Sockalingam S, Tremblay M. 'We are in for a culture change': continuing professional development leaders' perspectives on COVID-19, burn-out and structural inequities. BMJ LEADER 2024; 8:142-146. [PMID: 37739772 DOI: 10.1136/leader-2023-000837] [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: 04/25/2023] [Accepted: 09/09/2023] [Indexed: 09/24/2023]
Abstract
INTRODUCTION The COVID-19 pandemic positioned healthcare systems in North America at the epicentre of the crisis, placing inordinate stress on clinicians. Concurrently, discussions about structural racism, social justice and health inequities permeated the field of medicine, and society more broadly. The confluence of these phenomena required rapid action from continuing professional development (CPD) leaders to respond to emerging needs and challenges. METHODS In this qualitative study, researchers conducted 23 virtual semistructured interviews with CPD leaders in Canada and the USA. Interview audiorecordings were transcribed, deidentified and thematically analysed. RESULTS This study revealed that the CPD leaders attributed the pandemic as illuminating and exacerbating problems related to clinician wellness; equity, diversity and inclusion; and health inequities already prevalent in the healthcare system and within CPD. Analysis generated two themes: (1) From heroes to humans: the shifting view of clinicians and (2) Melding of crises: an opportunity for systemic change in CPD. DISCUSSION The COVID-19 pandemic increased recognition of burn-out and health inequities creating momentum in the field to prioritise and restrategise to address these converging public health crises. There is an urgent need for CPD to move beyond mere discourse on these topics towards holistic and sustainable actionable measures.
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Affiliation(s)
- Sophie Soklaridis
- Education Services, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
| | - Rabia Zaheer
- Education Services, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Michelle Scully
- Education Services, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Rowen Shier
- Education Services, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Betsy Williams
- Department of Psychiatry, University of Kansas School of Medicine, Kansas City, Kansas, USA
- Professional Renewal Centre, Lawrence, Kansas, USA
| | - Linda Dang
- Slaight Family Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Sam J Daniel
- Department of Pediatric Surgery, McGill University, Montreal, Québec, Canada
| | - Sanjeev Sockalingam
- Education Services, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
| | - Martin Tremblay
- Continuing Professional Development Department, Fédération des médecins spécialistes du Québec, Montreal, Québec, Canada
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Trinh Z, Cogswell I, Causey K. Impacts of the COVID-19 pandemic on healthcare utilization among Home Care Aides in Washington, U.S. Home Health Care Serv Q 2024:1-26. [PMID: 38940018 DOI: 10.1080/01621424.2024.2369079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Abstract
This study assesses the impacts of the COVID-19 pandemic on healthcare access for Washington State Home Care Aides (HCAs). Analyzing 62 months of medical claims data from over 35,000 HCAs, the research reveals significant healthcare disruptions during the early pandemic, especially in outpatient settings. However, healthcare utilization rebounded swiftly, surpassing pre-COVID levels as new variants emerged. Furthermore, the analysis indicated significant decreases in healthcare utilization for respiratory conditions in later stages of the pandemic, suggesting that the implementation of non-pharmaceutical and pharmaceutical interventions played a crucial role in preventing the transmission of respiratory diseases. Notably, behavioral health-related utilization among HCAs increased significantly throughout most pandemic phases, underscoring the importance of enhancing behavioral health support during public health crises. This research represents the first comprehensive study unveiling the effects of the COVID-19 pandemic on HCAs' healthcare access and opening avenues for further research and policy development to support this essential workforce.
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Affiliation(s)
- Zhenhui Trinh
- Health Benefits Trust, SEIU 775 Benefits Group, Seattle, USA
| | - Ian Cogswell
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Kate Causey
- Research, Insights & Innovation, SEIU 775 Benefits Group, Seattle, USA
- Department of Public Health, University of Washington
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Niemöller U, Tanislav C, Kostev K. Incidences for Fractures 2017-2021: What Do We Learn from the COVID-19 Pandemic? Healthcare (Basel) 2023; 11:2804. [PMID: 37893878 PMCID: PMC10606036 DOI: 10.3390/healthcare11202804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 10/29/2023] Open
Abstract
PURPOSE/INTRODUCTION In the present study, we aimed to assess the long-term incidence of fractures and during the COVID-19 pandemic. METHODS The current cohort study included patients who had received an initial fracture diagnosis of any type documented anonymously in the Disease Analyzer database (IQVIA) between 2017 and 2021 by physicians in 941 general practices in Germany. We investigated the development of fracture incidence over this period. RESULTS A total of 196,211 patients had a fracture diagnosis between 2017 and 2021. The number of patients with fracture diagnosis was highest in 2019 (n = 50,084) and lowest in 2020 (n = 46,227). The mean age of patients increased from 60.8 years in 2017 to 63.3 years in 2021. Between 58% and 60% of patients were female. From 2017 to 2019, the number of fractures documented in the younger age categories remained constant. Between 2019 and 2020, an incidence decrease was documented in the younger age groups (age group 16-40 years: -17.17%; age group 41-60 years: -18.71%; age group 61-80 years: -6.43%). By contrast, a slight increase of 3.03% was identified in the age group >80 years of age. No relevant changes in fracture incidences were noted between 2020 and 2021. Incidence rates decreased for both sexes from 2019 to 2020 (female patients: -6.27%; male patients: -10.18%). In the youngest age group (16-40 years), the decrease observed in 2020 was due to lower incidences for fractures of the upper and lower extremities (-11.9%; -12.5%) and ribs (-50.0%). In the age group ≥80 years, fracture incidences increased for the upper extremity (+2.8%), lower extremity (+8.3%), and femur (+8.3%). CONCLUSIONS The circumstances of the pandemic reduced the incidence of fractures in younger people, probably due to reduced recreational activities, while fracture incidence increased in older people, presumably as a result of lack of support.
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Affiliation(s)
- Ulrich Niemöller
- Department of Geriatrics and Neurology, Diakonie Hospital Jung Stilling Siegen, 57074 Siegen, Germany;
| | - Christian Tanislav
- Department of Geriatrics and Neurology, Diakonie Hospital Jung Stilling Siegen, 57074 Siegen, Germany;
| | - Karel Kostev
- Epidemiology, IQVIA, 60549 Frankfurt am Main, Germany
- Institute for Healthcare Research and Clinical Epidemiology, Philipps University Marburg, 35037 Marburg, Germany
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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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Tanislav C, Rosenbauer J, Kostev K. The COVID-19 Pandemic Enhanced the Decade-Long Trend of the Decreasing Utilization of Antibiotics. Antibiotics (Basel) 2023; 12:antibiotics12050927. [PMID: 37237830 DOI: 10.3390/antibiotics12050927] [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: 04/03/2023] [Revised: 05/04/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
PURPOSE/INTRODUCTION A decline in antibiotic (AB) prescriptions was reported during the coronavirus 2019 (COVID-19) pandemic. Therefore, we investigated AB utilization during the COVID-19 pandemic using data from a large database in Germany. METHODS AB prescriptions in the Disease Analyzer database (IQVIA) were analyzed for each year between 2011 and 2021. Descriptive statistics were used to assess developments in relation to age group, sex, and antibacterial substances. Infection incidence rates were also investigated. RESULTS In total, 1,165,642 patients received antibiotic prescriptions during the entire study period (mean age: 51.8; SD: 18.4 years; 55.3% females). AB prescriptions started to decline in 2015 (505 patients per practice), and this development persisted until 2021 (2020: 300 patients per practice and 2021: 266 patients per practice). The sharpest drop was observed in 2020 and occurred in both women and men (27.4% and 30.1%). In the youngest age group (≤30), the decrease was -56%, while in the age group >70, it was -38%. The number of patients with prescriptions for fluoroquinolones dropped the most, falling from 117 in 2015 to 35 in 2021 (-70%), followed by macrolides (-56%) and tetracyclines (-56%). In 2021, 46% fewer patients were diagnosed with acute lower respiratory infections, 19% fewer with chronic lower respiratory diseases, and just 10% fewer with diseases of the urinary system. CONCLUSION AB prescriptions decreased more in the first year (2020) of the COVID-19 pandemic than infectious diseases did. While the factor of older age influenced this trend negatively, it remained unaffected by the factor of sex and the selected antibacterial substance.
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Affiliation(s)
- Christian Tanislav
- Department of Geriatrics and Neurology, Diakonie Hospital Jung Stilling Siegen, Wichernstrasse 40, 57074 Siegen, Germany
| | - Josef Rosenbauer
- Department of Geriatrics and Neurology, Diakonie Hospital Jung Stilling Siegen, Wichernstrasse 40, 57074 Siegen, Germany
| | - Karel Kostev
- Epidemiology, IQVIA, 60549 Frankfurt am Main, Germany
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Zhang Y, Zhang J, Koura YH, Feng C, Su Y, Song W, Kong L. Multiple Concurrent Causal Relationships and Multiple Governance Pathways for Non-Pharmaceutical Intervention Policies in Pandemics: A Fuzzy Set Qualitative Comparative Analysis Based on 102 Countries and Regions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:931. [PMID: 36673700 PMCID: PMC9858854 DOI: 10.3390/ijerph20020931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/28/2022] [Accepted: 12/28/2022] [Indexed: 06/17/2023]
Abstract
The global outbreak of COVID-19 has been wreaking havoc on all aspects of human societies. In addition to pharmaceutical interventions, non-pharmaceutical intervention policies have been proven to be crucial in slowing down the spread of the virus and reducing the impact of the outbreak on economic development, daily life, and social stability. However, no studies have focused on which non-pharmaceutical intervention policies are more effective; this is the focus of our study. We used data samples from 102 countries and regions around the world and selected seven categories of related policies, including work and school suspensions, assembly restrictions, movement restrictions, home isolation, international population movement restrictions, income subsidies, and testing and screening as the condition variables. A susceptible-exposed-infected-quarantined-recovered (SEIQR) model considering non-pharmaceutical intervention policies and latency with infectiousness was constructed to calculate the epidemic transmission rate as the outcome variable, and a fuzzy set qualitative comparative analysis (fsQCA) method was applied to explore the multiple concurrent causal relationships and multiple governance paths of non-pharmaceutical intervention policies for epidemics from the configuration perspective. We found a total of four non-pharmaceutical intervention policy pathways. Among them, L1 was highly suppressive, L2 was moderately suppressive, and L3 was externally suppressive. The results also showed that individual non-pharmaceutical intervention policy could not effectively suppress the spread of the pandemic. Moreover, three specific non-pharmaceutical intervention policies, including work stoppage and school closure, testing and screening, and economic subsidies, had a universal effect in the policies grouping for effective control of the pandemic transmission.
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Affiliation(s)
- Yaming Zhang
- School of Economics and Management, Yanshan University, Qinhuangdao 066004, China
- Internet plus and Industrial Development Research Center, Yanshan University, Qinhuangdao 066004, China
| | - Jiaqi Zhang
- School of Economics and Management, Yanshan University, Qinhuangdao 066004, China
- Internet plus and Industrial Development Research Center, Yanshan University, Qinhuangdao 066004, China
| | - Yaya Hamadou Koura
- School of Foreign Languages, Yanshan University, Qinhuangdao 066004, China
| | - Changyuan Feng
- Business School, University of Granada, Campus Universitario de Cartuja, 18071 Granada, Spain
| | - Yanyuan Su
- School of Economics and Management, Yanshan University, Qinhuangdao 066004, China
- Internet plus and Industrial Development Research Center, Yanshan University, Qinhuangdao 066004, China
| | - Wenjie Song
- School of Economics and Management, Yanshan University, Qinhuangdao 066004, China
- Internet plus and Industrial Development Research Center, Yanshan University, Qinhuangdao 066004, China
| | - Linghao Kong
- School of Economics and Management, Yanshan University, Qinhuangdao 066004, China
- Internet plus and Industrial Development Research Center, Yanshan University, Qinhuangdao 066004, China
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Banholzer N, Lison A, Özcelik D, Stadler T, Feuerriegel S, Vach W. The methodologies to assess the effectiveness of non-pharmaceutical interventions during COVID-19: a systematic review. Eur J Epidemiol 2022; 37:1003-1024. [PMID: 36152133 PMCID: PMC9510554 DOI: 10.1007/s10654-022-00908-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/15/2022] [Indexed: 11/26/2022]
Abstract
Non-pharmaceutical interventions, such as school closures and stay-at-home orders, have been implemented around the world to control the spread of SARS-CoV-2. Their effectiveness in improving health-related outcomes has been the subject of numerous empirical studies. However, these studies show fairly large variation among methodologies in use, reflecting the absence of an established methodological framework. On the one hand, variation in methodologies may be desirable to assess the robustness of results; on the other hand, a lack of common standards can impede comparability among studies. To establish a comprehensive overview over the methodologies in use, we conducted a systematic review of studies assessing the effectiveness of non-pharmaceutical interventions between January 1, 2020 and January 12, 2021 (n = 248). We identified substantial variation in methodologies with respect to study setting, outcome, intervention, methodological approach, and effectiveness assessment. On this basis, we point to shortcomings of existing studies and make recommendations for the design of future studies.
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Affiliation(s)
- Nicolas Banholzer
- Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland.
| | - Adrian Lison
- Department of Biosystems Science and Engineering, ETH Zurich, Zurich, Switzerland.
| | - Dennis Özcelik
- Chemistry | Biology | Pharmacy Information Center, ETH Zurich, Zurich, Switzerland
| | - Tanja Stadler
- Department of Biosystems Science and Engineering, ETH Zurich, Zurich, Switzerland
| | - Stefan Feuerriegel
- Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
- LMU Munich School of Management, LMU Munich, Munich, Germany
| | - Werner Vach
- Basel Academy for Quality and Research in Medicine, Basel, Switzerland
- Department of Environmental Sciences, University of Basel, Basel, Switzerland
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Rahim R, Meliala A. Risk Mitigation Strategy against SARS-CoV-2 Infection for Healthcare Provider at Harapan Bersama General Hospital, Singkawang, Indonesia. Hosp Top 2022; 101:381-387. [PMID: 35549634 DOI: 10.1080/00185868.2022.2070090] [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: 10/18/2022]
Abstract
Working in one of the countries with highest number of COVID-19 cases, healthcare providers in Indonesia are at higher risk of contracting COVID-19. Therefore, risk mitigation strategy is crucial to protect the healthcare workers, especially in hospitals with limited resources such as Harapan Bersama General Hospital. This study aims to analyze risk mitigation strategy against SARS-CoV-2 infection for hospital workers in hospital with limited resource. Action Research study was performed through four stages. COVID-19 risk factor identification was carried out among healthcare workers who came in contact with COVID-19 patients between October 2020 and February 2021. Risk mitigation strategies were evaluated using Hospital Readiness Checklist for COVID-19. Implementation of risk mitigation strategies was done using hierarchy of control against infection transmission. Long period of close contact, inadequate PPE, and inadequate ventilation increased the risk of COVID-19 among healthcare workers.
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Affiliation(s)
- Rizki Rahim
- Hospital Management Program, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Andreasta Meliala
- Department of Health Management and Policy, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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12
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Investigation of the prevalence of non-COVID-19 infectious diseases during the COVID-19 pandemic. Public Health 2021; 203:53-57. [PMID: 35032915 PMCID: PMC8664655 DOI: 10.1016/j.puhe.2021.12.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/03/2021] [Accepted: 12/08/2021] [Indexed: 12/30/2022]
Abstract
Objectives This study aimed to investigate non-COVID-19-related upper respiratory tract infections (URTIs), gastrointestinal infections (GIIs) and urinary tract infections (UTIs) during the COVID-19 pandemic in Germany. Study design Cross-sectional study. Methods Patients with diagnoses of URTIs, GIIs and UTIs from 994 general practitioners (GP) and 192 paediatric practices that routinely send anonymous data to the Disease Analyzer database (IQVIA) were investigated. We studied the differences in recorded URTIs, GIIs and UTIs between April 2019–March 2020 (non-pandemic period) and April 2020–March 2021 (pandemic period) in terms of rates and baseline characteristics by comparing absolute frequencies. Results Compared with the non-pandemic period, the total number of patients with defined diagnoses was lower in the pandemic period (URTIs: 810,324 vs 520,800; GIIs: 253,029 vs 142,037; UTIs: 132,425 vs 117,932). The number of patients per practice with URTIs (683 vs 439, –36%, P < 0.001) and GIIs (213 vs 120, –44%, P < 0.001) decreased significantly during the pandemic period; the decrease in the number of recorded UTIs was smaller (112 vs 99, –11%, P < 0.05). The decrease in diagnoses was more pronounced among paediatricians than GPs (URTIs: −39% vs −35%; GIIs: −57% vs −39%; UTIs: −15% vs −9%). The decrease in URTIs varied between −35% and −40% depending on the age group. Conclusions Measures introduced during the COVID-19 pandemic to reduce transmission of the virus also helped to reduce the spread of non-COVID-19-related URTIs and GIIs. UTIs were impacted to a lesser extent, with rates seeing a slight decrease. An increase in awareness of infectious diseases may have also contributed to the reduction in recorded diagnoses.
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13
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Talic S, Shah S, Wild H, Gasevic D, Maharaj A, Ademi Z, Li X, Xu W, Mesa-Eguiagaray I, Rostron J, Theodoratou E, Zhang X, Motee A, Liew D, Ilic D. Effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality: systematic review and meta-analysis. BMJ 2021; 375:e068302. [PMID: 34789505 PMCID: PMC9423125 DOI: 10.1136/bmj-2021-068302] [Citation(s) in RCA: 274] [Impact Index Per Article: 91.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/21/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To review the evidence on the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality. DESIGN Systematic review and meta-analysis. DATA SOURCES Medline, Embase, CINAHL, Biosis, Joanna Briggs, Global Health, and World Health Organization COVID-19 database (preprints). ELIGIBILITY CRITERIA FOR STUDY SELECTION Observational and interventional studies that assessed the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality. MAIN OUTCOME MEASURES The main outcome measure was incidence of covid-19. Secondary outcomes included SARS-CoV-2 transmission and covid-19 mortality. DATA SYNTHESIS DerSimonian Laird random effects meta-analysis was performed to investigate the effect of mask wearing, handwashing, and physical distancing measures on incidence of covid-19. Pooled effect estimates with corresponding 95% confidence intervals were computed, and heterogeneity among studies was assessed using Cochran's Q test and the I2 metrics, with two tailed P values. RESULTS 72 studies met the inclusion criteria, of which 35 evaluated individual public health measures and 37 assessed multiple public health measures as a "package of interventions." Eight of 35 studies were included in the meta-analysis, which indicated a reduction in incidence of covid-19 associated with handwashing (relative risk 0.47, 95% confidence interval 0.19 to 1.12, I2=12%), mask wearing (0.47, 0.29 to 0.75, I2=84%), and physical distancing (0.75, 0.59 to 0.95, I2=87%). Owing to heterogeneity of the studies, meta-analysis was not possible for the outcomes of quarantine and isolation, universal lockdowns, and closures of borders, schools, and workplaces. The effects of these interventions were synthesised descriptively. CONCLUSIONS This systematic review and meta-analysis suggests that several personal protective and social measures, including handwashing, mask wearing, and physical distancing are associated with reductions in the incidence covid-19. Public health efforts to implement public health measures should consider community health and sociocultural needs, and future research is needed to better understand the effectiveness of public health measures in the context of covid-19 vaccination. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020178692.
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Affiliation(s)
- Stella Talic
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004 VIC, Australia
- Monash Outcomes Research and health Economics (MORE) Unit, Monash University, VIC, Australia
| | - Shivangi Shah
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004 VIC, Australia
| | - Holly Wild
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004 VIC, Australia
- Torrens University, VIC, Australia
| | - Danijela Gasevic
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004 VIC, Australia
- Centre for Global Health, The Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Ashika Maharaj
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004 VIC, Australia
| | - Zanfina Ademi
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004 VIC, Australia
- Monash Outcomes Research and health Economics (MORE) Unit, Monash University, VIC, Australia
| | - Xue Li
- Centre for Global Health, The Usher Institute, University of Edinburgh, Edinburgh, UK
- School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wei Xu
- Centre for Global Health, The Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Ines Mesa-Eguiagaray
- Centre for Global Health, The Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Jasmin Rostron
- Centre for Global Health, The Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Evropi Theodoratou
- Centre for Global Health, The Usher Institute, University of Edinburgh, Edinburgh, UK
- Cancer Research UK Edinburgh Centre, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Xiaomeng Zhang
- Centre for Global Health, The Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Ashmika Motee
- Centre for Global Health, The Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Danny Liew
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004 VIC, Australia
- Monash Outcomes Research and health Economics (MORE) Unit, Monash University, VIC, Australia
| | - Dragan Ilic
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004 VIC, Australia
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14
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Thomas Craig KJ, Rizvi R, Willis VC, Kassler WJ, Jackson GP. Effectiveness of Contact Tracing for Viral Disease Mitigation and Suppression: Evidence-Based Review. JMIR Public Health Surveill 2021; 7:e32468. [PMID: 34612841 PMCID: PMC8496751 DOI: 10.2196/32468] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/02/2021] [Accepted: 09/07/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Contact tracing in association with quarantine and isolation is an important public health tool to control outbreaks of infectious diseases. This strategy has been widely implemented during the current COVID-19 pandemic. The effectiveness of this nonpharmaceutical intervention is largely dependent on social interactions within the population and its combination with other interventions. Given the high transmissibility of SARS-CoV-2, short serial intervals, and asymptomatic transmission patterns, the effectiveness of contact tracing for this novel viral agent is largely unknown. OBJECTIVE This study aims to identify and synthesize evidence regarding the effectiveness of contact tracing on infectious viral disease outcomes based on prior scientific literature. METHODS An evidence-based review was conducted to identify studies from the PubMed database, including preprint medRxiv server content, related to the effectiveness of contact tracing in viral outbreaks. The search dates were from database inception to July 24, 2020. Outcomes of interest included measures of incidence, transmission, hospitalization, and mortality. RESULTS Out of 159 unique records retrieved, 45 (28.3%) records were reviewed at the full-text level, and 24 (15.1%) records met all inclusion criteria. The studies included utilized mathematical modeling (n=14), observational (n=8), and systematic review (n=2) approaches. Only 2 studies considered digital contact tracing. Contact tracing was mostly evaluated in combination with other nonpharmaceutical interventions and/or pharmaceutical interventions. Although some degree of effectiveness in decreasing viral disease incidence, transmission, and resulting hospitalizations and mortality was observed, these results were highly dependent on epidemic severity (R0 value), number of contacts traced (including presymptomatic and asymptomatic cases), timeliness, duration, and compliance with combined interventions (eg, isolation, quarantine, and treatment). Contact tracing effectiveness was particularly limited by logistical challenges associated with increased outbreak size and speed of infection spread. CONCLUSIONS Timely deployment of contact tracing strategically layered with other nonpharmaceutical interventions could be an effective public health tool for mitigating and suppressing infectious outbreaks by decreasing viral disease incidence, transmission, and resulting hospitalizations and mortality.
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Affiliation(s)
- Kelly Jean Thomas Craig
- Center for AI, Research, and Evaluation, IBM Watson Health, IBM Corporation, Cambridge, MA, United States
| | - Rubina Rizvi
- Center for AI, Research, and Evaluation, IBM Watson Health, IBM Corporation, Cambridge, MA, United States
| | - Van C Willis
- Center for AI, Research, and Evaluation, IBM Watson Health, IBM Corporation, Cambridge, MA, United States
| | - William J Kassler
- Center for AI, Research, and Evaluation, IBM Watson Health, IBM Corporation, Cambridge, MA, United States
- Palantir Technologies, Denver, CO, United States
| | - Gretchen Purcell Jackson
- Center for AI, Research, and Evaluation, IBM Watson Health, IBM Corporation, Cambridge, MA, United States
- Vanderbilt University Medical Center, Nashville, TN, United States
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15
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Tanislav C, Kostev K. Fewer non-COVID-19 respiratory tract infections and gastrointestinal infections during the COVID-19 pandemic. J Med Virol 2021; 94:298-302. [PMID: 34491581 PMCID: PMC8661971 DOI: 10.1002/jmv.27321] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/27/2021] [Accepted: 09/03/2021] [Indexed: 01/26/2023]
Abstract
For preventing the spread of the coronavirus disease 2019 (COVID‐19) pandemic, measures like wearing masks, social distancing, and hand hygiene played crucial roles. These measures may also have affected the expansion of other infectious diseases like respiratory tract infections (RTI) and gastro‐intestinal infections (GII). Therefore, we aimed to investigate non‐COVID‐19 related RTI and GII during the COVID‐19 pandemic. Patients with a diagnosis of an acute RTI (different locations) or acute GII documented anonymously in 994 general practitioner (GP) or 192 pediatrician practices in Germany were included. We compared the prevalence of acute RTI and GII between April 2019–March 2020 and April 2020–March 2021. In GP practices, 715,440 patients were diagnosed with RTI or GII in the nonpandemic period versus 468,753 in the pandemic period; the same trend was observed by pediatricians (275,033 vs. 165,127). By GPs, the strongest decrease was observed for the diagnosis of influenza (−71%, p < 0.001), followed by acute laryngitis (−64%, p < 0.001), acute lower respiratory infections (bronchitis) (−62%, p < 0.001), and intestinal infections (−40%, p < 0.001). In contrast, the relatively rare viral pneumonia strongly increased by 229% (p < 0.001). In pediatrician practices, there was a strong decrease in infection diagnoses, especially influenza (−90%, p < 0.001), pneumonia (−73%, p < 0.001 viral; −76%, p < 0.001 other pneumonias), and acute sinusitis (−66%, p < 0.001). No increase was observed for viral pneumonia in children. The considerable limitations concerning social life implemented during the COVID‐19 pandemic to combat the spread of SARS‐CoV‐2 also resulted in an inadvertent but welcome reduction in other non‐Covid‐19 respiratory tract and gastro‐intestinal infections. By general practices, in the pandemic time period, the strong decrease was observed for the diagnosis of influenza, acute laryngitis bronchitis, and intestinal infections. In contrast, the relatively rare viral pneumonia strongly increased in general practices. In pediatrician practices, there was a strong decrease in influenza, pneumonia, and acute sinusitis. No increase was observed for viral pneumonia in children.
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Affiliation(s)
- Christian Tanislav
- Department of Geriatrics and Neurology, Diakonie Hospital Jung Stilling, Siegen, Germany
| | - Karel Kostev
- Department of Epidemiology, IQVIA, Frankfurt am Main, Germany
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16
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Wang K, Wong ELY, Ho KF, Cheung AWL, Chan EYY, Wong SYS, Yeoh EK. Unequal availability of workplace policy for prevention of coronavirus disease 2019 across occupations and its relationship with personal protection behaviours: a cross-sectional survey. Int J Equity Health 2021; 20:200. [PMID: 34493292 PMCID: PMC8422060 DOI: 10.1186/s12939-021-01527-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 08/10/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The evolving pandemic of coronavirus disease 2019 (COVID-19) has become a severe threat to public health, and the workplace presents high risks in terms of spreading the disease. Few studies have focused on the relationship between workplace policy and individual behaviours. This study aimed to identify inequalities of workplace policy across occupation groups, examine the relationship of workplace guidelines and measures with employees' behaviours regarding COVID-19 prevention. METHODS A cross-sectional online survey using a structured questionnaire was conducted to gather employees' access to workplace guidelines and measures as well as their personal protection behaviours. Statistical associations between these two factors in different occupations were examined using multiple ordinal logistic regressions. RESULTS A total of 1048 valid responses across five occupational groups were analysed. Manual labourers reported lower availability of workplace guidelines and measures (76.9% vs. 89.9% for all, P = 0.003). Employees with available workplace guidelines and measures had higher compliance of hand hygiene, wearing masks, and social distancing, and this association was more significant among managers/administrators and manual labourers. CONCLUSIONS Protection of the quantity and quality of employment is important. Awareness about the disease and its prevention among employers and administrators should be promoted, and resources should be allocated to publish guidelines and implement measures in the workplace during the pandemic. Both work-from-home arrangement and other policies and responses for those who cannot work from home including guidelines encouraging the health behaviours, information transparency, and provision of infection control materials by employers should be established to reduce inequality. Manual labourers may require specific attention regarding accessibility of relevant information and availability of medical benefits and compensation for income loss due to the sickness, given their poorer experience of workplace policy and the nature of their work. Further studies are needed to test the effectiveness of specific workplace policies on COVID-19 prevention.
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Affiliation(s)
- Kailu Wang
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Eliza Lai Yi Wong
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Kin Fai Ho
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Annie Wai Ling Cheung
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Emily Ying Yang Chan
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Samuel Yeung Shan Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Eng Kiong Yeoh
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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17
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Wagatsuma K, Koolhof IS, Shobugawa Y, Saito R. Decreased human respiratory syncytial virus activity during the COVID-19 pandemic in Japan: an ecological time-series analysis. BMC Infect Dis 2021; 21:734. [PMID: 34344351 PMCID: PMC8329631 DOI: 10.1186/s12879-021-06461-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/21/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Non-pharmaceutical interventions (NPIs), such as sanitary measures and travel restrictions, aimed at controlling the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), may affect the transmission dynamics of human respiratory syncytial virus (HRSV). We aimed to quantify the contribution of the sales of hand hygiene products and the number of international and domestic airline passenger arrivals on HRSV epidemic in Japan. METHODS The monthly number of HRSV cases per sentinel site (HRSV activity) in 2020 was compared with the average of the corresponding period in the previous 6 years (from January 2014 to December 2020) using a monthly paired t-test. A generalized linear gamma regression model was used to regress the time-series of the monthly HRSV activity against NPI indicators, including sale of hand hygiene products and the number of domestic and international airline passengers, while controlling for meteorological conditions (monthly average temperature and relative humidity) and seasonal variations between years (2014-2020). RESULTS The average number of monthly HRSV case notifications in 2020 decreased by approximately 85% (p < 0.001) compared to those in the preceding 6 years (2014-2019). For every average ¥1 billion (approximately £680,000/$9,000,000) spent on hand hygiene products during the current month and 1 month before there was a 0.29% (p = 0.003) decrease in HRSV infections. An increase of average 1000 domestic and international airline passenger arrivals during the previous 1-2 months was associated with a 3.8 × 10- 4% (p < 0.001) and 1.2 × 10- 3% (p < 0.001) increase in the monthly number of HRSV infections, respectively. CONCLUSIONS This study suggests that there is an association between the decrease in the monthly number of HRSV cases and improved hygiene and sanitary measures and travel restrictions for COVID-19 in Japan, indicating that these public health interventions can contribute to the suppression of HRSV activity. These findings may help in public health policy and decision making.
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Affiliation(s)
- Keita Wagatsuma
- Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi dori, Chuo-ku, Niigata City, 951-8510, Japan.
| | - Iain S Koolhof
- College of Health and Medicine, School of Medicine, University of Tasmania, Hobart, Australia
| | - Yugo Shobugawa
- Department of Active Ageing (donated by Tokamachi city, Niigata, Japan), Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Reiko Saito
- Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi dori, Chuo-ku, Niigata City, 951-8510, Japan
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