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Willem L, Abrams S, Franco N, Coletti P, Libin PJK, Wambua J, Couvreur S, André E, Wenseleers T, Mao Z, Torneri A, Faes C, Beutels P, Hens N. The impact of quality-adjusted life years on evaluating COVID-19 mitigation strategies: lessons from age-specific vaccination roll-out and variants of concern in Belgium (2020-2022). BMC Public Health 2024; 24:1171. [PMID: 38671366 PMCID: PMC11047051 DOI: 10.1186/s12889-024-18576-w] [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: 10/27/2023] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND When formulating and evaluating COVID-19 vaccination strategies, an emphasis has been placed on preventing severe disease that overburdens healthcare systems and leads to mortality. However, more conventional outcomes such as quality-adjusted life years (QALYs) and inequality indicators are warranted as additional information for policymakers. METHODS We adopted a mathematical transmission model to describe the infectious disease dynamics of SARS-COV-2, including disease mortality and morbidity, and to evaluate (non)pharmaceutical interventions. Therefore, we considered temporal immunity levels, together with the distinct transmissibility of variants of concern (VOCs) and their corresponding vaccine effectiveness. We included both general and age-specific characteristics related to SARS-CoV-2 vaccination. Our scenario study is informed by data from Belgium, focusing on the period from August 2021 until February 2022, when vaccination for children aged 5-11 years was initially not yet licensed and first booster doses were administered to adults. More specifically, we investigated the potential impact of an earlier vaccination programme for children and increased or reduced historical adult booster dose uptake. RESULTS Through simulations, we demonstrate that increasing vaccine uptake in children aged 5-11 years in August-September 2021 could have led to reduced disease incidence and ICU occupancy, which was an essential indicator for implementing non-pharmaceutical interventions and maintaining healthcare system functionality. However, an enhanced booster dose regimen for adults from November 2021 onward could have resulted in more substantial cumulative QALY gains, particularly through the prevention of elevated levels of infection and disease incidence associated with the emergence of Omicron VOC. In both scenarios, the need for non-pharmaceutical interventions could have decreased, potentially boosting economic activity and mental well-being. CONCLUSIONS When calculating the impact of measures to mitigate disease spread in terms of life years lost due to COVID-19 mortality, we highlight the impact of COVID-19 on the health-related quality of life of survivors. Our study underscores that disease-related morbidity could constitute a significant part of the overall health burden. Our quantitative findings depend on the specific setup of the interventions under review, which is open to debate or should be contextualised within future situations.
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Affiliation(s)
- Lander Willem
- Department of Family Medicine and Population Health, Antwerp, Belgium.
- Centre for Health Economic Research and Modelling Infectious Diseases, University of Antwerp, Antwerp, Belgium.
| | - Steven Abrams
- Department of Family Medicine and Population Health, Antwerp, Belgium
- Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Nicolas Franco
- Data Science Institute, Hasselt University, Hasselt, Belgium
- Namur Institute for Complex Systems (naXys) and Department of Mathematics, University of Namur, Namur, Belgium
| | - Pietro Coletti
- Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Pieter J K Libin
- Data Science Institute, Hasselt University, Hasselt, Belgium
- Artificial Intelligence Lab, Vrije Universiteit Brussel, Brussels, Belgium
- Rega Institute for Medical Research, Clinical and Epidemiological Virology, University of Leuven, Leuven, Belgium
| | - James Wambua
- Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Simon Couvreur
- Department of Epidemiology and public health, Sciensano, Brussel, Belgium
| | - Emmanuel André
- National Reference Centre for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium
- Department of Microbiology, Immunology and Transplantation, University of Leuven, Leuven, Belgium
| | - Tom Wenseleers
- Laboratory of Socioecology and Social Evolution, University of Leuven, Leuven, Belgium
| | - Zhuxin Mao
- Centre for Health Economic Research and Modelling Infectious Diseases, University of Antwerp, Antwerp, Belgium
| | - Andrea Torneri
- Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Christel Faes
- Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Philippe Beutels
- Centre for Health Economic Research and Modelling Infectious Diseases, University of Antwerp, Antwerp, Belgium
- School of Public Health and Community Medicine, The University of New South Wales, Sydney, Australia
| | - Niel Hens
- Centre for Health Economic Research and Modelling Infectious Diseases, University of Antwerp, Antwerp, Belgium
- Data Science Institute, Hasselt University, Hasselt, Belgium
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Rzymski P, Pokorska-Śpiewak M, Jackowska T, Kuchar E, Nitsch-Osuch A, Pawłowska M, Babicki M, Jaroszewicz J, Szenborn L, Wysocki J, Flisiak R. Key Considerations during the Transition from the Acute Phase of the COVID-19 Pandemic: A Narrative Review. Vaccines (Basel) 2023; 11:1502. [PMID: 37766178 PMCID: PMC10537111 DOI: 10.3390/vaccines11091502] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 09/12/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
The COVID-19 pandemic has been met with an unprecedented response from the scientific community, leading to the development, investigation, and authorization of vaccines and antivirals, ultimately reducing the impact of SARS-CoV-2 on global public health. However, SARS-CoV-2 is far from being eradicated, continues to evolve, and causes substantial health and economic burdens. In this narrative review, we posit essential points on SARS-CoV-2 and its responsible management during the transition from the acute phase of the COVID-19 pandemic. As discussed, despite Omicron (sub)variant(s) causing clinically milder infections, SARS-CoV-2 is far from being a negligible pathogen. It requires continued genomic surveillance, particularly if one considers that its future (sub)lineages do not necessarily have to be milder. Antivirals and vaccines remain the essential elements in COVID-19 management. However, the former could benefit from further development and improvements in dosing, while the seasonal administration of the latter requires simplification to increase interest and tackle vaccine hesitancy. It is also essential to ensure the accessibility of COVID-19 pharmaceuticals and vaccines in low-income countries and improve the understanding of their use in the context of the long-term goals of SARS-CoV-2 management. Regardless of location, the primary role of COVID-19 awareness and education must be played by healthcare workers, who directly communicate with patients and serve as role models for healthy behaviors.
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Affiliation(s)
- Piotr Rzymski
- Department of Environmental Medicine, Poznan University of Medical Sciences, 60-806 Poznań, Poland
| | - Maria Pokorska-Śpiewak
- Department of Children’s Infectious Diseases, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Teresa Jackowska
- Department of Pediatrics, Centre for Postgraduate Medical Education, 01-813 Warsaw, Poland;
| | - Ernest Kuchar
- Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Aneta Nitsch-Osuch
- Department of Social Medicine and Public Health, Medical University of Warsaw, 02-007 Warsaw, Poland;
| | - Małgorzata Pawłowska
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, 85-067 Bydgoszcz, Poland;
| | - Mateusz Babicki
- Department of Family Medicine, Wroclaw Medical University, 51-141 Wroclaw, Poland;
| | - Jerzy Jaroszewicz
- Department of Infectious Diseases and Hepatology, Medical University of Silesia, 41-902 Bytom, Poland;
| | - Leszek Szenborn
- Department of Pediatric Infectious Diseases, Wrocław Medical University, 50-367 Wroclaw, Poland;
| | - Jacek Wysocki
- Department of Preventive Medicine, Poznan University of Medical Sciences, 61-701 Poznań, Poland;
| | - Robert Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Białystok, 15-089 Bialystok, Poland;
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Augustynowicz A, Bachurska B, Wójcik M, Borowska M, Czerw A, Opolski J, Słabicka K, Pinkas J. COVID-19-Infections and Immunization of Inmates in Penitentiary Institutions in Poland in 2021. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13725. [PMID: 36360605 PMCID: PMC9655023 DOI: 10.3390/ijerph192113725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 10/13/2022] [Accepted: 10/20/2022] [Indexed: 06/16/2023]
Abstract
Susceptibility to infection and the risk of a severe course of the disease caused by SARS-CoV-2 among inmates are greater than in the general population. Therefore, it is extremely important to control infections in penitentiary institutions and to vaccinate as many inmates as possible. The objectives of the study are to present the number and percentage of inmates quarantined, infected with the SARS CoV-2 virus, and vaccinated against COVID-19 in 2021, and to describe the rules and organization of immunization. The information presented in the study was obtained from the Ministry of Justice in the form of access to public information. In 2021, 2065 cases of SARS CoV-2 infection were detected among inmates, and 5707 people were quarantined. The waves of infections among inmates in Poland ran parallel to those in the general population. Immunization of inmates began at the turn of February and March 2021. It took place in accordance with the provisions of the National COVID-19 Immunization Program. The program ensured equality of the inmates' population with the group to which individual inmates belong in the community. In 2021, nearly half of the inmates were covered by the full vaccination course. Inmates were vaccinated immediately after the vaccines were made available. There have been cases of refusals among inmates. There are no data that could determine the magnitude of the phenomenon and its exact causes.
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Affiliation(s)
- Anna Augustynowicz
- Department of Economics and Medical Law, Medical University of Warsaw, 02-091 Warsaw, Poland
- School of Public Health, Centre of Postgraduate Medical Education of Warsaw, 01-813 Warsaw, Poland
| | - Beata Bachurska
- Institute of Legal Studies, College of Social Sciences, University of Rzeszów, 35-959 Rzeszów, Poland
| | - Michał Wójcik
- Faculty of Law and Administration, University of Silesia in Katowice, 40-007 Katowice, Poland
| | - Mariola Borowska
- Department of Economics and Medical Law, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Aleksandra Czerw
- Department of Economics and Medical Law, Medical University of Warsaw, 02-091 Warsaw, Poland
- Department of Economic and System Analyses, National Institute of Public Health—NIH—National Research Institute, 00-791 Warsaw, Poland
| | - Janusz Opolski
- Institute of Legal Studies, College of Social Sciences, University of Rzeszów, 35-959 Rzeszów, Poland
- Faculty of Engineering and Management, University of Ecology and Management in Warsaw, 00-792 Warsaw, Poland
| | | | - Jarosław Pinkas
- School of Public Health, Centre of Postgraduate Medical Education of Warsaw, 01-813 Warsaw, Poland
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Cardoso CW, Souza MMDS, Teles ACVDS, Argibay HD, Reis OBD, Pereira FM, Giovanetti M, Magalhaes T, Ribeiro GS. COVID-19 outbreaks among crew members in non-cruise vessels anchoring in Salvador, Brazil, 2021. Mem Inst Oswaldo Cruz 2022; 117:e220114. [DOI: 10.1590/0074-02760220114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 10/10/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | - Tereza Magalhaes
- Universidade Federal da Bahia, Brazil; Colorado State University, USA
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