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Lee K, Zhumatova S, Worsnop CZ, Bazak YL. Understanding the secondary outcomes of international travel measures during the covid-19 pandemic: a scoping review of social impact evidence. Global Health 2024; 20:59. [PMID: 39090727 PMCID: PMC11295557 DOI: 10.1186/s12992-024-01064-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Accepted: 07/24/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Assessment of the effective use of international travel measures during the COVID-19 pandemic has focused on public health goals, namely limiting virus introduction and onward transmission. However, risk-based approaches includes the weighing of public health goals against potential social, economic and other secondary impacts. Advancing risk-based approaches thus requires fuller understanding of available evidence on such impacts. METHODS We conducted a scoping review of existing studies of the social impacts of international travel measures during the COVID-19 pandemic. Applying a standardized typology of travel measures, and five categories of social impact, we searched 9 databases across multiple disciplines spanning public health and the social sciences. We identified 26 studies for inclusion and reviewed their scope, methods, type of travel measure, and social impacts analysed. RESULTS The studies cover a diverse range of national settings with a strong focus on high-income countries. A broad range of populations are studied, hindered in their outbound or inbound travel. Most studies focus on 2020 when travel restrictions were widely introduced, but limited attention is given to the broader effects of their prolonged use. Studies primarily used qualitative or mixed methods, with adaptations to comply with public health measures. Most studies focused on travel restrictions, as one type of travel measure, often combined with domestic public health measures, making it difficult to determine their specific social impacts. All five categories of social impacts were observed although there was a strong emphasis on negative social impacts including family separation, decreased work opportunities, reduced quality of life, and inability to meet cultural needs. A small number of countries identified positive social impacts such as restored work-life balance and an increase in perceptions of safety and security. CONCLUSIONS While international travel measures were among the most controversial interventions applied during the COVID-19 pandemic, given their prolonged use and widespread impacts on individuals and populations, there remains limited study of their secondary impacts. If risk-based approaches are to be advanced, involving informed choices between public health and other policy goals, there is a need to better understand such impacts, including their differential impacts across diverse populations and settings.
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Affiliation(s)
- Kelley Lee
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
- Pandemics and Borders Project, Faculty of Health Sciences, Simon Fraser University, Blusson Hall 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
| | - Salta Zhumatova
- Pandemics and Borders Project, Faculty of Health Sciences, Simon Fraser University, Blusson Hall 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
| | - Catherine Z Worsnop
- School of Public Policy, University of Maryland, College Park, MD, 20742, USA
| | - Ying Liu Bazak
- Pandemics and Borders Project, Faculty of Health Sciences, Simon Fraser University, Blusson Hall 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
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Holliday N, Mulear V. Effects of the COVID-19 Pandemic on the Wellbeing of LGBTQ+ Individuals in Moldova: A Mixed Methods Analysis. JOURNAL OF HOMOSEXUALITY 2024; 71:1808-1835. [PMID: 37129469 DOI: 10.1080/00918369.2023.2206935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Research on the effects of the COVID-19 pandemic for LGBTQ+ people is limited, particularly in eastern Europe. This mixed methods study explored the direct and indirect effects of the pandemic on the mental and physical wellbeing of LGBTQ+ individuals in Moldova. From June to the end of July 2022, 86 surveys and 12 interviews were completed by self-identified LGBTQ+ adults in Moldova. Survey data were analyzed with descriptive statistics and interviews were coded and analyzed using the grounded theory methodology. The two data sets were interpreted concurrently to identify emergent themes. Overall, data suggest LGBTQ+ people experienced both negative and positive effects on their mental wellbeing due to the pandemic. Participants expressed feelings of anxiety, loneliness, and depression, and an inability to be their authentic selves. Conversely, participants had more capacity to explore their identities and they demonstrated social support within the LGBTQ+ community. Regarding physical impacts, there were interruptions to transgender medical care and concerns about housing affordability. Findings highlight the unique impacts of the pandemic on LGBTQ+ people and stress the importance of further research in this area and policies and plans to address the needs of LGBTQ+ people in response to the pandemic and future health crises.
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Affiliation(s)
- Nicole Holliday
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Vahedi L, Stark L, Ding R, Masboungi C, Erskine D, Poulton C, Seff I. A qualitative investigation of gender-based violence prevention and response using digital technologies in low resource settings and refugee populations. Eur J Psychotraumatol 2024; 15:2347106. [PMID: 38722768 PMCID: PMC11085956 DOI: 10.1080/20008066.2024.2347106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 04/10/2024] [Indexed: 05/12/2024] Open
Abstract
Background: Governmental and non-governmental organizations across medical, legal, and psychosocial sectors providing care to survivors of gender-based violence (GBV) and their families rapidly digitalized services during the COVID-19 pandemic. GBV prevention/response services working with women and children who are forcibly displaced and/or living in low-and-middle income countries (LMIC) were no exception to the rapid digitalization trend. Literature is lacking a critical synthesis of best practices and lessons learned since digitalization replaced major operations involved in GBV prevention/response.Objective: This research qualitatively investigated how GBV service providers, located in a range of socio-political settings, navigated the process of digitalizing GBV prevention/response during the COVID-19 crisis.Method: Semi-structured key informant interviews (KII) with GBV service providers in varied sectors were implemented virtually (2020-2021) in Brazil, Guatemala, Iraq, and Italy (regarding forcibly displaced women/girls for the latter). Participants were recruited using purposive and snowball sampling. Interview guides covered a range of topics: perceived changes in violence and service provision, experiences with virtual services, system coordination, and challenges. The KIIs were conducted in Portuguese, Spanish, Arabic, and Italian. Interviews were audio-recorded, transcribed, and translated into English. The research team conducted thematic analysis within and between countries using a structured codebook of data driven and theory driven codes.Results: Major themes concerned the: (1) spectrum of services that were digitalized during the COVID-19 crisis; (2) gender digital divide as a barrier to equitable, safe, and effective service digitalization; (3) digital violence as an unintended consequence of increased digitalization across social/public services.Conclusion: Digitalization is a balancing act with respect to (1) the variety of remotely-delivered services that are possible and (2) the access/safety considerations related to the gender digital divide and digital violence.
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Affiliation(s)
- Luissa Vahedi
- Brown School, Washington University, St. Louis, MO, USA
| | - Lindsay Stark
- Brown School, Washington University, St. Louis, MO, USA
| | - Rachel Ding
- Brown School, Washington University, St. Louis, MO, USA
| | | | | | | | - Ilana Seff
- Brown School, Washington University, St. Louis, MO, USA
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Shachak A, Buchanan F, Kuziemsky C. When rules turn into tools: An activity theory-based perspective on implementation processes and unintended consequences. Healthc Manage Forum 2024; 37:177-182. [PMID: 38377181 PMCID: PMC11044511 DOI: 10.1177/08404704241233169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
The idea that actions of people, organizations or governments may lead to Unintended Consequences (UICs) is not new. In health, UICs have been reported as a result of various interventions including quality improvement initiatives, health information technology implementation, and knowledge translation, especially those involving translation of broad policies (evidence-based medicine and patient-centred care) or system level improvement into actionable items or tools. While some unintended consequences cannot be anticipated, others may be predictable. In this article, we present a model based on cultural historical activity theory, which may help policy-makers, health leaders, and researchers better anticipate UICs resulting from implementation of new programs or technologies and take action to address them or mitigate their risk of occurrence. We support this model using examples of UICs of implementing family centred care principles, electronic health records, and computerized templates for quality improvement in chronic disease management.
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Affiliation(s)
- Aviv Shachak
- University of Toronto, Toronto, Ontario, Canada
- The Wilson Centre for Research in Education, Toronto, Ontario, Canada
| | - Francine Buchanan
- University of Toronto, Toronto, Ontario, Canada
- The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
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Cherba M, Funk L, Scott E, Salman B, Rounce A, Mackenzie C, Stajduhar K, Dujela C, Krawczyk M, Cohen SR. How initial policy responses to COVID-19 contributed to shaping dying at home preferences and care provision: key informant perspectives from Canada. BMC Health Serv Res 2023; 23:1330. [PMID: 38037107 PMCID: PMC10691158 DOI: 10.1186/s12913-023-10340-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 11/17/2023] [Indexed: 12/02/2023] Open
Abstract
OBJECTIVES In response to COVID-19's first wave, provincial governments rapidly implemented several public health directives, including isolation measures and care facility visitor restrictions, which profoundly affected healthcare delivery at the end of life and dying experiences and perceptions. The objective of this study was to identify implications of early policy changes for dying at home. METHODS Analysis of interviews with 29 key informants with expertise in the policy and practice context of dying at home and care for those dying at home was conducted as part of a larger mixed-methods study on dying at home in Canada. RESULTS Initial pandemic policy responses, especially visitor restrictions and limitations to home care services, shaped dying at home in relation to three themes: (1) increasing preferences and demand for, yet constrained system ability to support dying at home; (2) reinforcing and illuminating systemic reliance on and need for family/friend caregivers and community organizations, while constraining their abilities to help people die at home; and (3) illuminating challenges in developing and implementing policy changes during a pandemic, including equity-related implications. CONCLUSION This study contributes to broader understanding of the multifaceted impacts of COVID-19 policy responses in various areas within Canadian healthcare systems. Implications for healthcare delivery and policy development include (1) recognizing the role of family/friend caregivers and community organizations in end-of-life care, (2) recognizing health inequities at the end of life, and (3) considering possible changes in future end-of-life preferences and public attitudes about dying at home and responsibility for end-of-life care.
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Affiliation(s)
| | - Laura Funk
- University of Manitoba, Winnipeg, Canada
| | - Erin Scott
- University of Manitoba, Winnipeg, Canada
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Ashby E, Minicucci C, Liao J, Buonsenso D, González-Dambrauskas S, Obregón R, Zahn M, Hallman W, John C. Systems Thinking for Public Health: A Case Study Using U.S. Public Education. NAM Perspect 2023; 2023:202311a. [PMID: 38784633 PMCID: PMC11114595 DOI: 10.31478/202311a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Affiliation(s)
| | | | - Julie Liao
- National Academies of Sciences, Engineering, and Medicine
| | | | | | | | - Matt Zahn
- Children's Hospital of Orange County
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Gagnon-Dufresne MC, Gautier L, Beaujoin C, Boivin P, Coulibaly A, Richard Z, Gomes de Medeiros S, Dutra Da Nóbrega RE, de Araujo Oliveira SR, Cloos P, Chabrol F, Ridde V, Zinszer K. Did the design and planning of testing and contact tracing interventions for COVID-19 consider social inequalities in health? A multiple case study from Brazil, Canada, France & Mali. Soc Sci Med 2023; 335:116230. [PMID: 37716184 DOI: 10.1016/j.socscimed.2023.116230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 09/04/2023] [Accepted: 09/07/2023] [Indexed: 09/18/2023]
Abstract
The COVID-19 pandemic has led to an unprecedented global crisis. It has exposed and exacerbated weaknesses in public health systems worldwide, particularly with regards to reaching the most vulnerable populations, disproportionately impacted by the pandemic. The objective of our study was to examine whether and how social inequalities in health (SIH) were considered in the design and planning of public health responses to COVID-19 in jurisdictions of Brazil, Canada, France, and Mali. This article reports on a qualitative multiple case study of testing and contact tracing interventions in regions with high COVID-19 incidence in each country, namely: Manaus (Brazil), Montréal (Canada), Île-de-France (France), and Bamako (Mali). We conducted interviews with 108 key informants involved in these interventions in the four jurisdictions, focusing on the first and second waves of the pandemic. We analyzed our data thematically using a theoretical bricolage framework. Our analysis suggests that the lack of a common understanding of SIH among all actors involved and the sense of urgency brought by the pandemic eclipsed the prioritization of SIH in the initial responses. The pandemic increased intersectoral collaboration, but decision-making power was often unequal between Ministries of Health and other actors in each jurisdiction. Various adaptations to COVID-19 interventions were implemented to reach certain population groups, therefore improving the accessibility, availability, and acceptability of testing and contact tracing. Our study contributes to identifying lessons learned from the current pandemic, namely that the ways in which SIH are understood shape how interventions are planned; that having clear guidelines on how to integrate SIH into public health interventions could lead to more inclusive pandemic responses; that for intersectoral collaboration to be fruitful, there needs to be sufficient resources and equitable decision-making power between partners; and that interventions must be flexible to respond to emerging needs while considering long-standing structural inequalities.
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Affiliation(s)
- Marie-Catherine Gagnon-Dufresne
- School of Public Health, University of Montréal, 7101 Avenue Du Parc, Montréal, QC, H3N 1X9, Canada; Centre de Recherche en Santé Publique (CReSP), 1301 Rue Sherbrooke Est, Montréal, QC, H3L 1M3, Canada.
| | - Lara Gautier
- School of Public Health, University of Montréal, 7101 Avenue Du Parc, Montréal, QC, H3N 1X9, Canada; Centre de Recherche en Santé Publique (CReSP), 1301 Rue Sherbrooke Est, Montréal, QC, H3L 1M3, Canada.
| | - Camille Beaujoin
- School of Public Health, University of Montréal, 7101 Avenue Du Parc, Montréal, QC, H3N 1X9, Canada.
| | - Pauline Boivin
- Unité de Recherche en Sciences Sociales Miseli, Ilot N°17, Cité El Farako, P.O. Box E 5448, Bamako, Mali.
| | - Abdourahmane Coulibaly
- Unité de Recherche en Sciences Sociales Miseli, Ilot N°17, Cité El Farako, P.O. Box E 5448, Bamako, Mali.
| | - Zoé Richard
- Université Paris Cité, Institut de Recherche pour le Développement (IRD), Institut National de La Santé et de La Recherche Médicale (INSERM), Centre Population et Développement (CEPED), 45 Rue des Saints-Pères, F-75006, Paris, France.
| | - Stéphanie Gomes de Medeiros
- Federal University of Pernambuco, Av. Prof. Moraes Rego, 1235 - Cidade Universitária, Recife PE 50670-901, Brazil.
| | - Raylson Emanuel Dutra Da Nóbrega
- Aggeu Magalhães Research Center, Oswaldo Cruz Foundation, Federal University of Pernambuco, Av. Prof. Moraes Rego - Cidade Universitária, Recife PE 50740-465, Brazil.
| | - Sydia Rosana de Araujo Oliveira
- Aggeu Magalhães Research Center, Oswaldo Cruz Foundation, Federal University of Pernambuco, Av. Prof. Moraes Rego - Cidade Universitária, Recife PE 50740-465, Brazil.
| | - Patrick Cloos
- School of Public Health, University of Montréal, 7101 Avenue Du Parc, Montréal, QC, H3N 1X9, Canada; Centre de Recherche en Santé Publique (CReSP), 1301 Rue Sherbrooke Est, Montréal, QC, H3L 1M3, Canada; School of Social Work, University of Montréal, 3150 Rue Jean-Brillant, Montréal, QC, H3T 1N8, Canada.
| | - Fanny Chabrol
- Université Paris Cité, Institut de Recherche pour le Développement (IRD), Institut National de La Santé et de La Recherche Médicale (INSERM), Centre Population et Développement (CEPED), 45 Rue des Saints-Pères, F-75006, Paris, France.
| | - Valéry Ridde
- Université Paris Cité, Institut de Recherche pour le Développement (IRD), Institut National de La Santé et de La Recherche Médicale (INSERM), Centre Population et Développement (CEPED), 45 Rue des Saints-Pères, F-75006, Paris, France.
| | - Kate Zinszer
- School of Public Health, University of Montréal, 7101 Avenue Du Parc, Montréal, QC, H3N 1X9, Canada; Centre de Recherche en Santé Publique (CReSP), 1301 Rue Sherbrooke Est, Montréal, QC, H3L 1M3, Canada.
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Diallo I, Ndejjo R, Leye MMM, Egbende L, Tusubira A, Bamgboye EA, Fall M, Namuhani N, Bosonkie M, Salawu MM, Ndiaye Y, Kabwama SN, Sougou NM, Bello S, Bassoum O, Babirye Z, Afolabi RF, Gueye T, Kizito S, Adebowale AS, Dairo MD, Sambisa W, Kiwanuka SN, Fawole OI, Mapatano MA, Wanyenze RK, Seck I. Unintended consequences of implementing non-pharmaceutical interventions for the COVID-19 response in Africa: experiences from DRC, Nigeria, Senegal, and Uganda. Global Health 2023; 19:36. [PMID: 37280682 DOI: 10.1186/s12992-023-00937-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/19/2023] [Indexed: 06/08/2023] Open
Abstract
INTRODUCTION The coronavirus (COVID 19) pandemic is one of the most terrifying disasters of the twenty-first century. The non-pharmaceutical interventions (NPIs) implemented to control the spread of the disease had numerous positive consequences. However, there were also unintended consequences-positively or negatively related to the nature of the interventions, the target, the level and duration of implementation. This article describes the unintended economic, Psychosocial and environmental consequences of NPIs in four African countries. METHODS We conducted a mixed-methods study in the Democratic Republic of Congo (DRC), Nigeria, Senegal and Uganda. A comprehensive conceptual framework, supported by a clear theory of change was adopted to encompass both systemic and non-systemic interventions. The data collection approaches included: (i) review of literature; (ii) analysis of secondary data for selected indicators; and (ii) key informant interviews with policy makers, civil society, local leaders, and law enforcement staff. The results were synthesized around thematic areas. RESULTS Over the first six to nine months of the pandemic, NPIs especially lockdowns, travel restrictions, curfews, school closures, and prohibition of mass gathering resulted into both positive and negative unintended consequences cutting across economic, psychological, and environmental platforms. DRC, Nigeria, and Uganda observed reduced crime rates and road traffic accidents, while Uganda also reported reduced air pollution. In addition, hygiene practices have improved through health promotion measures that have been promoted for the response to the pandemic. All countries experienced economic slowdown, job losses heavily impacting women and poor households, increased sexual and gender-based violence, teenage pregnancies, and early marriages, increased poor mental health conditions, increased waste generation with poor disposal, among others. CONCLUSION Despite achieving pandemic control, the stringent NPIs had several negative and few positive unintended consequences. Governments need to balance the negative and positive consequences of NPIs by anticipating and instituting measures that will support and protect vulnerable groups especially the poor, the elderly, women, and children. Noticeable efforts, including measures to avoid forced into marriage, increasing inequities, economic support to urban poor; those living with disabilities, migrant workers, and refugees, had been conducted to mitigate the negative effects of the NIPs.
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Affiliation(s)
- Issakha Diallo
- Public Health Department, Faculty of Health Sciences, University Amadou Hampaté Ba, Dakar, Senegal.
| | - Rawlance Ndejjo
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Mamadou Makhtar Mbacké Leye
- Preventive Medicine and Public Health Department within the Faculty of Medicine, Pharmacy and Dentistry, University Cheikh Anta Diop of Dakar, Dakar, Senegal
| | - Landry Egbende
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Andrew Tusubira
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Eniola A Bamgboye
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Manel Fall
- Epidemiology Department of Pasteur Institute of Dakar, Dakar, Senegal
| | - Noel Namuhani
- Department of Health Policy, Planning and Management, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Marc Bosonkie
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Mobolaji M Salawu
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Youssoupha Ndiaye
- Health Economics Unit of the Ministry of Health and Social Action, Dakar, Senegal
| | - Steven Ndugwa Kabwama
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Ndeye Mareme Sougou
- Preventive Medicine and Public Health Department within the Faculty of Medicine, Pharmacy and Dentistry, University Cheikh Anta Diop of Dakar, Dakar, Senegal
| | - Segun Bello
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Omar Bassoum
- Preventive Medicine and Public Health Department within the Faculty of Medicine, Pharmacy and Dentistry, University Cheikh Anta Diop of Dakar, Dakar, Senegal
| | - Ziyada Babirye
- Department of Health Policy, Planning and Management, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Rotimi Felix Afolabi
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Thiané Gueye
- Health Economics Unit of the Ministry of Health and Social Action, Dakar, Senegal
| | - Susan Kizito
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Ayo S Adebowale
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Magbagbeola David Dairo
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Suzanne N Kiwanuka
- Department of Health Policy, Planning and Management, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Olufunmilayo I Fawole
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Mala Ali Mapatano
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Rhoda K Wanyenze
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Ibrahima Seck
- Preventive Medicine and Public Health Department within the Faculty of Medicine, Pharmacy and Dentistry, University Cheikh Anta Diop of Dakar, Dakar, Senegal
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Branson RD, Rodriquez D. COVID-19 Lessons Learned: Response to the Anticipated Ventilator Shortage. Respir Care 2023; 68:129-150. [PMID: 36566030 PMCID: PMC9993519 DOI: 10.4187/respcare.10676] [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: 12/26/2022]
Abstract
Early in the COVID-19 pandemic predictions of a worldwide ventilator shortage prompted a worldwide search for solutions. The impetus for the scramble for ventilators was spurred on by inaccurate and often unrealistic predictions of ventilator requirements. Initial efforts looked simply at acquiring as many ventilators as possible from national and international sources. Ventilators from the Strategic National Stockpile were distributed to early hotspots in the Northeast and Northwest United States. In a triumph of emotion over logic, well-intended experts from other industries turned their time, talent, and treasure toward making a ventilator for the first time. Interest in shared ventilation (more than one patient per ventilator) was ignited by an ill-advised video on social media that ignored the principles of gas delivery in deference to social media notoriety. With shared ventilation, a number of groups mistook a physiologic problem for a plumbing problem. The United States government invoked the Defense Production Act to push automotive manufacturers to partner with existing ventilator manufacturers to speed production. The FDA granted emergency use authorization for "splitters" to allow shared ventilation as well as for ventilators and ancillary equipment. Rationing of ventilators was discussed in the lay press and medical literature but was never necessary in the US. Finally, planners realized that staff with expertise in providing mechanical ventilation were the most important shortage. Over 200,000 ventilators were purchased by the United States government, states, cities, health systems, and individuals. Most had little value in caring for patients with COVID-19 ARDS. This paper attempts to look at where miscalculations were made, with an eye toward what we can do better in the future.
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Affiliation(s)
- Richard D Branson
- Division of Trauma/Critical Care, Department of Surgery, University of Cincinnati, Cincinnati, Ohio.
| | - Dario Rodriquez
- Division of Trauma/Critical Care, Department of Surgery, University of Cincinnati, Cincinnati, Ohio; and Airman Biosciences Division, Airman Systems Directorate, Wright-Patterson Air Force Base, Dayton, Ohio
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Ingham G, Kippen R. Should I stay or should I go? Observation post-vaccination during the COVID-19 pandemic and the law of unintended consequences. Aust J Prim Health 2022; 28:542-548. [PMID: 36070885 DOI: 10.1071/py22074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/05/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Standard practice after all vaccinations in Australia is to observe patients for 15min. During the coronavirus disease 2019 (COVID-19) pandemic, could the risk of contracting and dying from COVID-19 acquired in the waiting room be greater than the risk of dying from post-vaccine anaphylaxis when leaving immediately? METHODS The risks are modelled for a patient aged 70+years attending for annual influenza vaccination in a typical Australian general practice clinic. The risk of death from anaphylaxis is estimated based on known rates of anaphylaxis shortly after influenza vaccination. The risk of acquiring COVID-19 during a 15-min wait and then dying from that infection is estimated using the COVID-19 Aerosol Transmission Estimator and COVID-19 Risk Calculator. RESULTS Other than at times of extremely low COVID-19 prevalence, the risk of death from anaphylaxis for a patient aged 70+years leaving immediately after influenza vaccine is less than the risk of death from COVID-19 acquired via aerosol transmission during a 15-min wait. The risk of death from COVID-19 is greatest for the unimmunised and when masks are not worn. CONCLUSIONS A more nuanced approach to advice post-vaccination is recommended that considers current COVID-19 prevalence and virulence, the characteristics of the waiting room, the risk of anaphylaxis, and the patient's susceptibility to death from COVID-19. There are many circumstances where it would be safer for a patient to leave immediately after vaccination.
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Affiliation(s)
- Gerard Ingham
- Springs Medical, 10 Hospital Street, Daylesford, Vic., Australia; and School of Rural Health, Monash University, Bendigo, Vic., Australia
| | - Rebecca Kippen
- School of Rural Health, Monash University, Bendigo, Vic., Australia
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11
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Sturmberg J, Paul E, Van Damme W, Ridde V, Brown GW, Kalk A. The danger of the single storyline obfuscating the complexities of managing SARS-CoV-2/COVID-19. J Eval Clin Pract 2022; 28:1173-1186. [PMID: 34825442 DOI: 10.1111/jep.13640] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/11/2021] [Accepted: 11/12/2021] [Indexed: 12/15/2022]
Abstract
Chimamanda Ngozi Adichie showed how a single story is limited and thereby distorts the true nature of an issue. During this COVID-19 pandemic there have been, at least, three consecutive single stories-the 'lethal threat' story, followed by the 'economic threat' story, and finally the 'vaccine miracle' story. None of these single stories can convincingly and permanently capture the dynamics of the pandemic. This is because countries experienced different morbidity and mortality patterns, different socioeconomic disadvantage, age and vulnerability of population, timing and level of lockdown with economic variability, and, despite heavy promotion, vaccines were beset with a significant and variable degree of hesitancy. Lack of transparency, coherence and consistency of pandemic management-arising from holding on to single storylines-showed the global deficiency of public health policy and planning, an underfunding of (public) health and social services, and a growing distrust in governments' ability to manage crises effectively. Indeed, the global management has increased already large inequities, and little has been learnt to address the growing crises of more infectious and potentially more lethal virus mutations. Holding onto single stories prevents the necessary learnings to understand and manage the complexities of 'wicked' problems, whereas listening to the many stories provides insights and pathways to do so effectively as well as efficiently.
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Affiliation(s)
- Joachim Sturmberg
- Discipline of General Practice, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, New South Wales, Australia.,Foundation President-International Society for Systems and Complexity Sciences for Health
| | - Elisabeth Paul
- School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| | - Wim Van Damme
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Valery Ridde
- CEPED, Institute for Research on Sustainable Development (IRD), ERL INSERM SAGESUD, IRD-Université de Paris, Paris, France
| | - Garrett W Brown
- Colead-Global Health, School of Politics and International Studies (POLIS), University of Leeds, Leeds, UK
| | - Andreas Kalk
- Kinshasa Country Office, Deutsche Gesellschaft für Internationale Zusammenarbeit, Kinshasa, Democratic Republic of the Congo
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12
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Wrabel M, Stokes‐Walters R, King S, Funnell G, Stobaugh H. Programmatic adaptations to acute malnutrition screening and treatment during the COVID‐19 pandemic. MATERNAL & CHILD NUTRITION 2022; 18:e13406. [PMID: 35929509 PMCID: PMC9480950 DOI: 10.1111/mcn.13406] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 06/13/2022] [Accepted: 06/21/2022] [Indexed: 11/30/2022]
Abstract
The COVID‐19 pandemic presented numerous challenges to acute malnutrition screening and treatment. To enable continued case identification and service delivery while minimising transmission risks, many organisations and governments implemented adaptations to community‐based management of acute malnutrition (CMAM) programmes for children under 5. These included: Family mid‐upper arm circumference (MUAC); modified admission and discharge criteria; modified dosage of therapeutic foods; and reduced frequency of follow‐up visits. This paper presents qualitative findings from a larger mixed methods study to document practitioners' operational experiences and lessons learned from these adaptations. Findings reflect insights from 37 interviews representing 15 organisations in 17 countries, conducted between July 2020 and January 2021. Overall, interviewees indicated that adaptations were mostly well‐accepted by staff, caregivers and communities. Family MUAC filled screening gaps linked to COVID‐19 disruptions; however, challenges included long‐term accuracy of caregiver measurements; implementing an intervention that could increase demand for inconsistent services; and limited guidance to monitor programme quality and impact. Modified admission and discharge criteria and modified dosage streamlined logistics and implementation with positive impacts on staff workload and caregiver understanding of the programme. Reduced frequency of visits enabled social distancing by minimising crowding at facilities and lessened caregivers' need to travel. Concerns remained about how adaptations impacted children's identification for and progress through treatment and programme outcomes. Most respondents anticipated reverting to standard protocols once transmission risks were mitigated. Further evidence, including multi‐year programmatic data analysis and rigorous research, is needed in diverse contexts to understand adaptations' impacts, including how to ensure equity and mitigate unintended consequences. COVID‐19 CMAM programme adaptations enabled service continuity despite pandemic‐related challenges. Further evidence is needed on long‐term impacts. Family MUAC was well‐accepted and addressed screening gaps from COVID‐19 disruptions. Challenges included sustaining caregiver measurement accuracy; handling inaccurate self‐referrals to encourage health‐seeking behaviours; and limited programme design and monitoring guidance and tools. Modified admission criteria and therapeutic food dosage reduced contact between staff and children and streamlined logistics and implementation. Concerns remained about effects on programme admissions and outcomes. Reduced frequency of follow‐up visits successfully reduced facility crowding and need for caregiver travel. However, infrequent monitoring of childrenmay miss deterioration.
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Affiliation(s)
| | | | - Sarah King
- Action Against Hunger USA Washington, DC USA
| | | | - Heather Stobaugh
- Action Against Hunger USA Washington, DC USA
- Friedman School of Nutrition Science and Policy Tufts University Boston Massachusetts USA
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Kratzer S, Pfadenhauer LM, Biallas RL, Featherstone R, Klinger C, Movsisyan A, Rabe JE, Stadelmaier J, Rehfuess E, Wabnitz K, Verboom B. Unintended consequences of measures implemented in the school setting to contain the COVID-19 pandemic: a scoping review. Cochrane Database Syst Rev 2022; 6:CD015397. [PMID: 35661990 PMCID: PMC9169532 DOI: 10.1002/14651858.cd015397] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND With the emergence of SARS-CoV-2 in late 2019, governments worldwide implemented a multitude of non-pharmaceutical interventions in order to control the spread of the virus. Most countries have implemented measures within the school setting in order to reopen schools or keep them open whilst aiming to contain the spread of SARS-CoV-2. For informed decision-making on implementation, adaptation, or suspension of such measures, it is not only crucial to evaluate their effectiveness with regard to SARS-CoV-2 transmission, but also to assess their unintended consequences. OBJECTIVES To comprehensively identify and map the evidence on the unintended health and societal consequences of school-based measures to prevent and control the spread of SARS-CoV-2. We aimed to generate a descriptive overview of the range of unintended (beneficial or harmful) consequences reported as well as the study designs that were employed to assess these outcomes. This review was designed to complement an existing Cochrane Review on the effectiveness of these measures by synthesising evidence on the implications of the broader system-level implications of school measures beyond their effects on SARS-CoV-2 transmission. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, four non-health databases, and two COVID-19 reference collections on 26 March 2021, together with reference checking, citation searching, and Google searches. SELECTION CRITERIA We included quantitative (including mathematical modelling), qualitative, and mixed-methods studies of any design that provided evidence on any unintended consequences of measures implemented in the school setting to contain the SARS-CoV-2 pandemic. Studies had to report on at least one unintended consequence, whether beneficial or harmful, of one or more relevant measures, as conceptualised in a logic model. DATA COLLECTION AND ANALYSIS: We screened the titles/abstracts and subsequently full texts in duplicate, with any discrepancies between review authors resolved through discussion. One review author extracted data for all included studies, with a second review author reviewing the data extraction for accuracy. The evidence was summarised narratively and graphically across four prespecified intervention categories and six prespecified categories of unintended consequences; findings were described as deriving from quantitative, qualitative, or mixed-method studies. MAIN RESULTS Eighteen studies met our inclusion criteria. Of these, 13 used quantitative methods (3 experimental/quasi-experimental; 5 observational; 5 modelling); four used qualitative methods; and one used mixed methods. Studies looked at effects in different population groups, mainly in children and teachers. The identified interventions were assigned to four broad categories: 14 studies assessed measures to make contacts safer; four studies looked at measures to reduce contacts; six studies assessed surveillance and response measures; and one study examined multiple measures combined. Studies addressed a wide range of unintended consequences, most of them considered harmful. Eleven studies investigated educational consequences. Seven studies reported on psychosocial outcomes. Three studies each provided information on physical health and health behaviour outcomes beyond COVID-19 and environmental consequences. Two studies reported on socio-economic consequences, and no studies reported on equity and equality consequences. AUTHORS' CONCLUSIONS We identified a heterogeneous evidence base on unintended consequences of measures implemented in the school setting to prevent and control the spread of SARS-CoV-2, and summarised the available study data narratively and graphically. Primary research better focused on specific measures and various unintended outcomes is needed to fill knowledge gaps and give a broader picture of the diverse unintended consequences of school-based measures before a more thorough evidence synthesis is warranted. The most notable lack of evidence we found was regarding psychosocial, equity, and equality outcomes. We also found a lack of research on interventions that aim to reduce the opportunity for contacts. Additionally, study investigators should provide sufficient data on contextual factors and demographics in order to ensure analyses of such are feasible, thus assisting stakeholders in making appropriate, informed decisions for their specific circumstances.
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Affiliation(s)
- Suzie Kratzer
- Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Lisa M Pfadenhauer
- Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Renke L Biallas
- Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | | | - Carmen Klinger
- Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Ani Movsisyan
- Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Julia E Rabe
- Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Julia Stadelmaier
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Eva Rehfuess
- Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Katharina Wabnitz
- Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Ben Verboom
- Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
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14
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Bwire G, Ario AR, Eyu P, Ocom F, Wamala JF, Kusi KA, Ndeketa L, Jambo KC, Wanyenze RK, Talisuna AO. The COVID-19 pandemic in the African continent. BMC Med 2022; 20:167. [PMID: 35501853 PMCID: PMC9059455 DOI: 10.1186/s12916-022-02367-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 04/05/2022] [Indexed: 01/13/2023] Open
Abstract
In December 2019, a new coronavirus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and associated disease, coronavirus disease 2019 (COVID-19), was identified in China. This virus spread quickly and in March, 2020, it was declared a pandemic. Scientists predicted the worst scenario to occur in Africa since it was the least developed of the continents in terms of human development index, lagged behind others in achievement of the United Nations sustainable development goals (SDGs), has inadequate resources for provision of social services, and has many fragile states. In addition, there were relatively few research reporting findings on COVID-19 in Africa. On the contrary, the more developed countries reported higher disease incidences and mortality rates. However, for Africa, the earlier predictions and modelling into COVID-19 incidence and mortality did not fit into the reality. Therefore, the main objective of this forum is to bring together infectious diseases and public health experts to give an overview of COVID-19 in Africa and share their thoughts and opinions on why Africa behaved the way it did. Furthermore, the experts highlight what needs to be done to support Africa to consolidate the status quo and overcome the negative effects of COVID-19 so as to accelerate attainment of the SDGs.
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Affiliation(s)
- Godfrey Bwire
- grid.415705.2Department of Integrated Epidemiology Surveillance and Public Health Emergencies, Ministry of Health, P.O Box 7272, Kampala, Uganda
- grid.11194.3c0000 0004 0620 0548School of Public Health, Makerere University, P.O. Box 7072, Kampala, Uganda
| | | | - Patricia Eyu
- Uganda National Institute of Public Health, Kampala, Uganda
| | - Felix Ocom
- Uganda National Institute of Public Health, Kampala, Uganda
| | | | - Kwadwo A. Kusi
- grid.8652.90000 0004 1937 1485Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Latif Ndeketa
- grid.419393.50000 0004 8340 2442Malawi-Liverpool-Wellcome Programme (MLW), Blantyre, Malawi
| | - Kondwani C. Jambo
- grid.419393.50000 0004 8340 2442Malawi-Liverpool-Wellcome Programme (MLW), Blantyre, Malawi
- grid.48004.380000 0004 1936 9764Liverpool School of Tropical Medicine, Liverpool, UK
| | - Rhoda K. Wanyenze
- grid.11194.3c0000 0004 0620 0548School of Public Health, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Ambrose O. Talisuna
- grid.463718.f0000 0004 0639 2906Epidemic Preparedness and Response Cluster, World Health Organization, Regional Office for Africa, Brazzaville, Congo
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15
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Ridde V, Faye A. Challenges in Implementing the National Health Response to COVID-19 in Senegal. GLOBAL IMPLEMENTATION RESEARCH AND APPLICATIONS 2022; 2:219-233. [PMID: 35967834 PMCID: PMC9361250 DOI: 10.1007/s43477-022-00053-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/26/2022] [Indexed: 04/27/2023]
Abstract
UNLABELLED Since the beginning of the COVID-19 pandemic in Africa, many epidemiological or anthropological studies have been published. However, few studies have yet been conducted to understand the implementation of State interventions to fight the COVID-19 pandemic. In Senegal, the national response plan was planned before the country experienced its first official case of COVID-19 on 2 March 2020. This qualitative study, conducted in March and April 2021, based on 189 interviews, aims to understand how the national response has been implemented in several regions of Senegal. Implementation of the response to the pandemic was favoured by good preparation, capacity to adapt, responsiveness of health actors, and commitment for both the political and religious authorities. The implementation response was confronted by several constraining factors such as the coercive approach, the challenges of coordinating actors, and the lack of intersectoral response. The central level has sometimes used reflexivity processes to adapt its response, but it has remained highly politicized, centralized, directive, and with little involvement of civil society. In Senegal, the response to the pandemic has been implemented in a relatively political and directive, even coercive manner, without necessarily considering prior knowledge and the need to adapt it to local contexts and to involve civil society and community actors in the process. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s43477-022-00053-4.
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Affiliation(s)
- Valéry Ridde
- Institute of Health and Development (ISED), Cheikh Anta Diop University, Dakar, Senegal
- Université Paris Cité, IRD, Inserm, Ceped, 75006 Paris, France
| | - Adama Faye
- Institute of Health and Development (ISED), Cheikh Anta Diop University, Dakar, Senegal
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16
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Trkman M, Popovič A, Trkman P. The impact of perceived crisis severity on intention to use voluntary proximity tracing applications. INTERNATIONAL JOURNAL OF INFORMATION MANAGEMENT 2021; 61:102395. [DOI: 10.1016/j.ijinfomgt.2021.102395] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 07/26/2021] [Accepted: 07/28/2021] [Indexed: 01/10/2023]
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17
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Klinger C, Burns J, Movsisyan A, Biallas R, Norris SL, Rabe JE, Stratil JM, Voss S, Wabnitz K, Rehfuess EA, Verboom B. Unintended health and societal consequences of international travel measures during the COVID-19 pandemic: a scoping review. J Travel Med 2021; 28:taab123. [PMID: 34369562 PMCID: PMC8436381 DOI: 10.1093/jtm/taab123] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/18/2021] [Accepted: 07/27/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND/OBJECTIVE International travel measures to contain the coronavirus disease of 2019 (COVID-19) pandemic represent a relatively intrusive form of non-pharmaceutical intervention. To inform decision-making on the (re)implementation, adaptation, relaxation or suspension of such measures, it is essential to not only assess their effectiveness but also their unintended effects. METHODS This scoping review maps existing empirical studies on the unintended consequences, both predicted and unforeseen, and beneficial or harmful, of international travel measures. We searched multiple health, non-health and COVID-19-specific databases. The evidence was charted in a map in relation to the study design, intervention and outcome categories identified and discussed narratively. RESULTS Twenty-three studies met our inclusion criteria-nine quasi-experimental, two observational, two mathematical modelling, six qualitative and four mixed-methods studies. Studies addressed different population groups across various countries worldwide. Seven studies provided information on unintended consequences of the closure of national borders, six looked at international travel restrictions and three investigated mandatory quarantine of international travellers. No studies looked at entry and/or exit screening at national borders exclusively, however six studies considered this intervention in combination with other international travel measures. In total, 11 studies assessed various combinations of the aforementioned interventions. The outcomes were mostly referred to by the authors as harmful. Fifteen studies identified a variety of economic consequences, six reported on aspects related to quality of life, well-being, and mental health and five on social consequences. One study each provided information on equity, equality, and the fair distribution of benefits and burdens, environmental consequences and health system consequences. CONCLUSION This scoping review represents the first step towards a systematic assessment of the unintended benefits and harms of international travel measures during COVID-19. The key research gaps identified might be filled with targeted primary research, as well as the additional consideration of gray literature and non-empirical studies.
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Affiliation(s)
- Carmen Klinger
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Pettenkofer School of Public Health, Chair of Public Health and Health Services Research, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
| | - Jacob Burns
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Pettenkofer School of Public Health, Chair of Public Health and Health Services Research, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
| | - Ani Movsisyan
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Pettenkofer School of Public Health, Chair of Public Health and Health Services Research, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
| | - Renke Biallas
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Pettenkofer School of Public Health, Chair of Public Health and Health Services Research, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
| | - Susan L Norris
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Pettenkofer School of Public Health, Chair of Public Health and Health Services Research, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Department of Family Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA
| | - Julia E Rabe
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Pettenkofer School of Public Health, Chair of Public Health and Health Services Research, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
| | - Jan M Stratil
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Pettenkofer School of Public Health, Chair of Public Health and Health Services Research, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
| | - Stephan Voss
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Pettenkofer School of Public Health, Chair of Public Health and Health Services Research, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
| | - Katharina Wabnitz
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Pettenkofer School of Public Health, Chair of Public Health and Health Services Research, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
| | - Eva A Rehfuess
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Pettenkofer School of Public Health, Chair of Public Health and Health Services Research, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
| | - Ben Verboom
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Pettenkofer School of Public Health, Chair of Public Health and Health Services Research, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Department of Social Policy and Intervention, University of Oxford, Barnett House, 32 Wellington Square Oxford OX1 2ER
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18
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Paul E, Brown GW, Kalk A, Ridde V. Playing vaccine roulette: Why the current strategy of staking everything on Covid-19 vaccines is a high-stakes wager. Vaccine 2021; 39:4921-4924. [PMID: 34315610 PMCID: PMC8289694 DOI: 10.1016/j.vaccine.2021.07.045] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/14/2021] [Accepted: 07/16/2021] [Indexed: 12/15/2022]
Affiliation(s)
- Elisabeth Paul
- Université libre de Bruxelles, School of Public Health, Campus Erasme, Route de Lennik 808, CP 591, 1070 Brussels, Belgium.
| | - Garrett W Brown
- University of Leeds, Global Health Theme, POLIS, Leeds, United Kingdom.
| | - Andreas Kalk
- Deutsche Gesellschaft für Internationale Zusammenarbeit, Kinshasa Country Office, Kinshasa, The Democratic Republic of the Congo.
| | - Valéry Ridde
- Institut de Recherche pour le Développement (IRD), CEPED (IRD-Universités de Paris), INSERM, Paris, France.
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Surapaneni KM, Kaur M, Kaur R, Grover A, Joshi A. Examine the impact of COVID-19 Vaccine Communication, Acceptance and Practice (CO-VIN-CAP) on Vaccine hesitancy in an Indian setting: Protocol for a Cross-Sectional Study. JMIR Res Protoc 2021; 10:e29733. [PMID: 34086594 PMCID: PMC8386355 DOI: 10.2196/29733] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/10/2021] [Accepted: 05/13/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND COVID-19 vaccine is considered to be a key to limiting and eliminating infectious disease. But, the success of the vaccination program will rely on the rates of vaccine acceptance among the population. OBJECTIVE The objective of this study is to examine the factors that influence vaccine hesitancy and vaccine acceptance and to explore the unintended consequences of COVID-19 infections. The study will further explore the association between socio-demographic characteristics, health status, COVID-19 related knowledge, attitude, practice, and its influence on Vaccine hesitancy and acceptance among individuals living in urban and rural settings of Chennai, Tamil Nadu in the Southern state of India. METHODS A cross-sectional study will be conducted between January 2021 and January 2023. A sample of approximately 25,000 individuals will be recruited and enrolled using a non-probability complete enumeration sampling method from eleven selected urban and rural settings of Chennai. The data will be collected at a one-time point by administering the questionnaire to the eligible study participants. The collected data will be used to assess the rates of vaccine acceptance, hesitancy as well as knowledge, attitudes, practices, and beliefs regarding COVID-19 and COVID-19 vaccine. Lastly, the study questionnaire will be used to assess the unintended consequences of COVID-19 infection. RESULTS A pilot of 2500 individuals has been conducted to pre-test the self-administered study questionnaire. The data collection initiated on March 1, 2021 and the initial results are planned for publication by June 2021. Descriptive analysis of the gathered data will be performed using Statistical Analysis System (SAS) v9.1 and reporting of the results will be done at 95% confidence interval and P=.049. The study will help explore the burden of vaccine acceptance and hesitancy among individuals living in urban and rural settings of Chennai. Further, it will help to examine the variables that influence vaccine acceptance and hesitancy. Lastly, the result findings will help to design and develop a user-centered informatics platform that can deliver multimedia-driven health educational modules tailored to facilitate vaccine uptake in varied settings. CONCLUSIONS The proposed study will help in understanding the rate and determinants of COVID-19 vaccine acceptance and hesitancy among the population of Chennai. The findings of the study would further facilitate the development of a multifaceted intervention to enhance vaccine acceptance among the population. CLINICALTRIAL
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Affiliation(s)
- Krishna Mohan Surapaneni
- Panimalar Medical College Hospital & Research Institute, Varadharajapuram, Poonamallee, Chennai, Tamil Nadu, Chennai, IN
| | - Mahima Kaur
- Foundation of Healthcare Technologies Society, 625, 6th Floor Ansal Chamber - 2, Bhikaji Cama Place, New Delhi, Delhi - 110066, Delhi, IN
| | - Ritika Kaur
- SMAART Population Health Informatics Intervention Center, Foundation of Healthcare Technologies Society - Panimalar Medical College Hospital & Research Institute, Varadharajapuram, Poonamallee, Chennai, Tamil Nadu - 600123, Chennai, IN
| | - Ashoo Grover
- Indian Council of Medical Research, Ansari Nagar, New Delhi - 110029, Delhi, IN
| | - Ashish Joshi
- City University of New York Graduate School of Public Health and Health Policy, 55W 125th street, NY 10027, New York, US
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