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Hill EB, Mastny-Jensen C, Loch C. Before and after: COVID-19 impacts on dental students' well-being, clinical competency and employment opportunities. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2024; 28:522-529. [PMID: 38009831 DOI: 10.1111/eje.12977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 08/27/2023] [Accepted: 10/18/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION The onset of COVID-19 challenged dental schools worldwide, impacting clinical training. In Australasia, New Zealand adopted a COVID-19 'elimination strategy', involving nationwide lockdowns that halted face-to-face education. The 'elimination strategy' adopted at the pandemic onset, which permitted return to 'normal life' in 2021, allowed the pandemic impacts and those related workforce transition to be teased out. This study aimed to evaluate perceived impacts of the COVID-19 pandemic on health and well-being, clinical competency and employment opportunities of dental students. MATERIALS AND METHODS Two surveys were distributed to final year dental students (n = 94; age range 20-35): one during their final semester and the second six months following graduation. Surveys included open and closed ended questions on participants' self-perceived impacts of COVID-19 on health and well-being, clinical competency and employment opportunities. Average percentages were calculated and descriptive statistics performed. RESULTS Pre-graduation, participants reported COVID-19 negatively impacted their mental and social health. Slightly lower scores on all dimensions of health post-graduation were likely due to transitioning to the workforce. Pre-graduation, less than half of participants felt prepared to provide the full scope of dental treatment; post-graduation most felt confident to do so. Most participants expected COVID-19 would negatively impact employment opportunities for their cohort, despite all participants being employed when the second survey was conducted. CONCLUSION Participants self-rated health and clinical competency scores were lower post-graduation when NZ returned to 'normal life', meaning lower scores were related to workforce transition. Dental schools need to be prepared to provide alternative forms of dental education and help mitigate mental health impacts of future major course disruptions.
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Affiliation(s)
- Eva Barron Hill
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Chevvy Mastny-Jensen
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Carolina Loch
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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Yun EK, Han JW, Kim JO, Jung S, Cha J, Yoo K, Min S, Yang B. Analyzing Korean Public Health Centers' Infectious Disease Disaster Response Experiences with a Focus on Business Continuity. Risk Manag Healthc Policy 2024; 17:789-801. [PMID: 38595753 PMCID: PMC11001540 DOI: 10.2147/rmhp.s448382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 03/23/2024] [Indexed: 04/11/2024] Open
Abstract
Objective This study aims to provide basic data for establishing strategies to maintain the core functions of health centers, and enable an effective response to emergency tasks in the event of future infectious disease disasters. Methods The participants were 41 workers from two public health centers in Seoul. They all had prior experience in responding to the early and middle stages of the COVID-19 pandemic. Data were collected through Focus Group Discussions, and then analyzed using the deductive method of content analysis. Results The participants' experiences during the infectious disease disaster crisis were examined through ten categories: governance and coordination, information management, human resources, essential medical supplies and equipment, infrastructure, administration, finance and logistics, community engagement and risk communication, delivery of essential services, security, and additional considerations for vulnerable populations. The analysis of the results made it apparent that new systems and policies were imperative for responding appropriately to the concerns and experiences of the public healthcare center staff, and for improving the response to future epidemics. Conclusion We found that to prepare for infectious disaster situations in the future, it is necessary for health centers to establish a mid- to long-term business continuity plan to ensure the continuation and stability of their operations. Additionally, it was found that health professionals in public health centers also believe in the necessity of education and training programs on disaster preparedness, based on Business Continuity Planning proposed by the World Health Organization. They deem these essential to sustain routine tasks for the management of the health of local community residents during outbreaks of novel infectious diseases in the future.
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Affiliation(s)
- Eun Kyoung Yun
- College of nursing science, Kyung Hee University, Seoul, Republic of Korea
| | - Jeong-Won Han
- College of nursing science, Kyung Hee University, Seoul, Republic of Korea
| | - Jung Ok Kim
- College of nursing science, Kyung Hee University, Seoul, Republic of Korea
| | - Sungmo Jung
- College of nursing science, Kyung Hee University, Seoul, Republic of Korea
| | - Jeongeun Cha
- College of nursing science, Kyung Hee University, Seoul, Republic of Korea
| | - Keunhee Yoo
- College of nursing science, Kyung Hee University, Seoul, Republic of Korea
| | - Soyoon Min
- College of nursing science, Kyung Hee University, Seoul, Republic of Korea
| | - Boeun Yang
- College of nursing science, Kyung Hee University, Seoul, Republic of Korea
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Bisen AC, Agrawal S, Sanap SN, Ravi Kumar HG, Kumar N, Gupta R, Bhatta RS. COVID-19 retreats and world recovers: A silver lining in the dark cloud. HEALTH CARE SCIENCE 2023; 2:264-285. [PMID: 38939523 PMCID: PMC11080794 DOI: 10.1002/hcs2.57] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 05/30/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2024]
Abstract
The coronavirus disease (COVID-19), which the World Health Organization classified as the Sixth Public Health Emergency Of International Concern (PHEIC) on January 30, 2020, is no longer a PHEIC. Millions were affected due to unawareness. The increase in fatalities and shortage of medicine was the first outrage of COVID-19. As per the Johns Hopkins COVID-19 resource center database, it was observed that the disease has spread dynamically across 200+ nations worldwide affecting more than 600 million people from 2019 to 2023, and over thousands of people were victimized regularly at a 2% mortality rate (approx.). In the midway, the mutant variants of concern like omicron, and delta have also created havoc and caused significant impact on public health, global economy, and lifestyle. Since 2019, 3 years now passed and the dynamic disease statistics seem decelerated; moreover, the prevalence of COVID-19 is also fading. The Johns Hopkins resource center has also stopped recording the data of the global pandemic recently from March 10, 2023. Hence, based on the facts, we are presenting a concise report on the pandemic from 2019 to 2023, which includes a brief discussion of the global pandemic. We have highlighted global epidemiology, emphasizing the Indian COVID scenario, vaccination across the globe, and the psychosocial and geopolitical consequences of COVID-19 with a brief background to pathology, clinical management, and the worldwide response against triage. A lot has changed and still needs to change after three tough years of COVID-19. Even though science has progressed and advanced research in medicine is pointing toward future generations, there is no standard care supplied for COVID-19-like calamities. COVID-19 cases might have declined but its influence on the society is still stagnant. This COVID experience has taught us that, despite our bleak beginnings, there is always hope for the future and that we must act with foresight to improve things for future generations.
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Affiliation(s)
- Amol Chhatrapati Bisen
- Pharmaceutics and Pharmacokinetics DivisionCSIR—Central Drug Research InstituteLucknowUttar PradeshIndia
- Academy of Scientific and Innovative Research (AcSIR)GhaziabadUttar PradeshIndia
| | - Sristi Agrawal
- Pharmaceutics and Pharmacokinetics DivisionCSIR—Central Drug Research InstituteLucknowUttar PradeshIndia
- Academy of Scientific and Innovative Research (AcSIR)GhaziabadUttar PradeshIndia
| | - Sachin Nashik Sanap
- Pharmaceutics and Pharmacokinetics DivisionCSIR—Central Drug Research InstituteLucknowUttar PradeshIndia
- Academy of Scientific and Innovative Research (AcSIR)GhaziabadUttar PradeshIndia
| | | | - Nelam Kumar
- Biochemistry and Structural Biology DivisionCSIR—Central Drug Research InstituteLucknowUttar PradeshIndia
- Present address:
International Centre for Translational Eye Research (ICTER)Institute of Physical Chemistry (IChF)Marcina Kasprzaka 44/5201‐224WarsawPoland
| | - Rajdeep Gupta
- Pharmaceutics and Pharmacokinetics DivisionCSIR—Central Drug Research InstituteLucknowUttar PradeshIndia
| | - Rabi Sankar Bhatta
- Pharmaceutics and Pharmacokinetics DivisionCSIR—Central Drug Research InstituteLucknowUttar PradeshIndia
- Academy of Scientific and Innovative Research (AcSIR)GhaziabadUttar PradeshIndia
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Trask S, Lockyer P, Hildreth J, D'Souza E, Buklijas T, Menzies R, Vickers M, Bay JL. Sustaining youth physical activity in times of challenge and change: lessons from COVID-19. Health Promot Int 2023; 38:7151547. [PMID: 37140347 PMCID: PMC10158528 DOI: 10.1093/heapro/daad038] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Abstract
Physical activity (PA) is recognized as essential for positive physical and mental well-being in young people. However, participation in PA is known to decline as adolescents emerge into adulthood under the influence of complex social and structural factors. Globally, COVID-19 restrictions resulted in changes to PA and PA participation levels in youth populations, providing a unique opportunity for gaining insight into PA barriers and enablers in circumstances of challenge, limitation and change. This article details young people's self-reported PA behaviours during the 4-week 2020 COVID-19 lockdown in New Zealand. Taking a strengths-based view and drawing on the COM-B (capabilities, opportunity and motivation behaviour) model for behaviour change, the study explores factors enabling young people to sustain or increase PA during lockdown. Findings are drawn from qualitative-dominant mixed-methods analyses of responses to an online questionnaire: New Zealand Youth Voices Matter (16-24 years; N = 2014). Key insights included the importance of habit and routine, time and flexibility, social connections, incidental exercise and awareness of links between PA and well-being. Of note were the positive attitudes, creativity and resiliency demonstrated as young people substituted or invented alternatives to their usual PA. PA needs to change to adapt to new circumstances over the life course, and youth understanding and knowledge of modifiable factors may provide support for this. Thus these findings have implications for sustaining PA during late adolescence and emerging adulthood, a life phase that can be associated with significant challenge and change.
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Affiliation(s)
- Suzanne Trask
- Liggins Institute, University of Auckland, Park Road, Grafton, Auckland, New Zealand
| | - Peg Lockyer
- Liggins Institute, University of Auckland, Park Road, Grafton, Auckland, New Zealand
| | - Jillian Hildreth
- Liggins Institute, University of Auckland, Park Road, Grafton, Auckland, New Zealand
| | - Erica D'Souza
- Liggins Institute, University of Auckland, Park Road, Grafton, Auckland, New Zealand
| | | | | | - Mark Vickers
- Liggins Institute, University of Auckland, Park Road, Grafton, Auckland, New Zealand
| | - Jacquie L Bay
- Liggins Institute, University of Auckland, Park Road, Grafton, Auckland, New Zealand
- Koi Tū Centre for Informed Futures, University of Auckland
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Boselli PM, Soriano JM. COVID-19 in Italy: Is the Mortality Analysis a Way to Estimate How the Epidemic Lasts? BIOLOGY 2023; 12:biology12040584. [PMID: 37106784 PMCID: PMC10135801 DOI: 10.3390/biology12040584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/25/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023]
Abstract
When an epidemic breaks out, many health, economic, social, and political problems arise that require a prompt and effective solution. It would be useful to obtain all information about the virus, including epidemiological ones, as soon as possible. In a previous study of our group, the analysis of the positive-alive was proposed to estimate the epidemic duration. It was stated that every epidemic ends when the number of positive-alive (=infected-healed-dead) glides toward zero. In fact, if with the contagion everyone can enter the epidemic phenomenon, only by healing or dying can they get out of it. In this work, a different biomathematical model is proposed. A necessary condition for the epidemic to be resolved is that the mortality reaches the asymptotic value, from there, remains stable. At that time, the number of positive-alive must also be close to zero. This model seems to allow us to interpret the entire development of the epidemic and highlight its phases. It is also more appropriate than the previous one, especially when the spread of the infection is so rapid that the increase in live positives is staggering.
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Affiliation(s)
- Pietro M Boselli
- Group of Nutritional Modelling Biology, Departament de Biosciencies, University of Milan, 20122 Milan, Italy
| | - Jose M Soriano
- Food & Health Lab, Institute of Materials Science, University of Valencia, 46980 Paterna, Spain
- Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics, Health Research Institute La Fe-University of Valencia, 46026 Valencia, Spain
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Putri DIP, Agustian D, Apriani L, Ilyas R. Spatial and Temporal Analysis of COVID-19 Cases in West Java, Indonesia and Its Influencing Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3198. [PMID: 36833893 PMCID: PMC9960347 DOI: 10.3390/ijerph20043198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/20/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
Coronavirus Disease 2019 (COVID-19) spread quickly and reached epidemic levels worldwide. West Java is Indonesia's most populous province and has a high susceptibility to the transmission of the disease, resulting in a significant number of COVID-19 cases. Therefore, this research aimed to determine the influencing factors as well as the spatial and temporal distribution of COVID-19 in West Java. Data on COVID-19 cases in West Java obtained from PIKOBAR were used. Spatial distribution was described using a choropleth, while the influencing factors were evaluated with regression analysis. To determine whether COVID-19s policies and events affected its temporal distribution, the cases detected were graphed daily or biweekly with information on those two variables. Furthermore, the cumulative incidence was described in the linear regression analysis model as being significantly influenced by vaccinations and greatly elevated by population density. The biweekly chart had a random pattern with sharp decreases or spikes in cumulative incidence changes. Spatial and temporal analysis helps greatly in understanding distribution patterns and their influencing factors, specifically at the beginning of the pandemic. Plans and strategies for control and assessment programs may be supported by this study material.
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Affiliation(s)
- Delima Istio Prawiradhani Putri
- Epidemiology Study Program, Faculty of Medicine, Universitas Padjadjaran, Jalan Eyckman No. 38 Gedung RSP Unpad Lantai 4, Bandung 40161, Indonesia
| | - Dwi Agustian
- Division Epidemiology and Biostatistics, Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Jalan Ir. Soekarno KM. 21, Jatinangor, Sumedang 45363, Indonesia
| | - Lika Apriani
- Division Epidemiology and Biostatistics, Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Jalan Ir. Soekarno KM. 21, Jatinangor, Sumedang 45363, Indonesia
| | - Ridwan Ilyas
- Informatics Department, Faculty of Science and Informatics, Universitas Jenderal Achmad Yani, Jalan Terusan Jenderal Sudirman, Cimahi 40531, Indonesia
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Koziol-McLain J, Cowley C, Nayar S, Koti D. Impact of COVID-19 on the Health Response to Family Violence in Aotearoa New Zealand: A Qualitative Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580221146832. [PMID: 36710509 PMCID: PMC9895298 DOI: 10.1177/00469580221146832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
COVID-19 pandemic planning and response has resulted in unprecedented upheaval within health systems internationally. With a concern for increasing frequency and escalation of family violence, the so called "shadow pandemic," we wondered how health system violence intervention programs were operating during this time. In Aotearoa New Zealand, the Ministry of Health Violence Intervention Program (VIP), using a systems approach, seeks to reduce and prevent the health impacts of family violence and abuse through early identification, assessment, and referral of victims presenting to designated health services. In this qualitative descriptive study, we explored how the VIP program was impacted during the first year of the COVID-19 pandemic. Forty-one VIP coordinators and managers representing 15 of the 20 New Zealand District Health Boards and the National VIP Team participated. Across 12 focus groups (8 face to face and 4 via Zoom) and 7 individual interviews (all via Zoom) participants shared their experience navigating systems to support frontline health providers' responsiveness to people impacted by family violence during the pandemic. In our reflexive thematic analysis, we generated 3 themes: Responding to the moment, valuing relationships, and reflecting on the status quo. Our findings demonstrate the dynamic environment in which participants found creative ways to adapt to the uncertainty and engage with communities to re-shape interventions and ensure continued implementation of the program. At the same time, challenges within the system prior to the pandemic were brought into view and highlighted the need for action. These included, for example, the need for improved engagement with Māori (Indigenous people of Aotearoa New Zealand) to address long-standing health inequities. Having quality essential services for those impacted by family violence that engages with local knowledge and networks and routinely copes with uncertainty will strengthen our systems to minimize risk of harm during emergencies.
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Affiliation(s)
- Jane Koziol-McLain
- Auckland University of Technology, Auckland, New Zealand,Jane Koziol-McLain, School of Clinical Sciences, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand.
| | | | - Shoba Nayar
- Auckland University of Technology, Auckland, New Zealand
| | - Diane Koti
- Auckland University of Technology, Auckland, New Zealand
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Wang S, Zhang Y, Zhang Q, Lu Q, Liu C, Yi F. A Strategy Formulation Framework for Efficient Screening during the Early Stage of a Pandemic. Trop Med Infect Dis 2023; 8:tropicalmed8020078. [PMID: 36828494 PMCID: PMC9960745 DOI: 10.3390/tropicalmed8020078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 01/25/2023] Open
Abstract
For viruses that can be transmitted by contacts of people, efficiently screening infected individuals is beneficial for controlling outbreaks rapidly and avoiding widespread diffusion, especially during the early stage of a pandemic. The process of virus transmission can be described as virus diffusion in complex networks such as trajectory networks. We propose a strategy formulation framework (SFF) for generating various screening strategies to identify influential nodes in networks. We propose two types of metrics to measure the nodes' influence and three types of screening modes. Then, we can obtain six combinations, i.e., six strategies. To verify the efficiencies of the strategies, we build a scenario model based on the multi-agent modelling. In this model, people can move according to their self-decisions, and a virtual trajectory network is generated by their contacts. We found that (1) screening people will have a better performance based on their contact paths if there is no confirmed case yet, and (2) if the first confirmed case has been discovered, it is better to screen people sequentially by their influences. The proposed SFF and strategies can provide support for decision makers, and the proposed scenario model can be applied to simulate and forecast the virus-diffusion process.
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Affiliation(s)
- Shuangyan Wang
- Party School of the Central Committee of C.P.C. (National Academy of Governance), Beijing 100089, China
| | - Yuan Zhang
- School of Social Development and Public Policy, Beijing Normal University, Beijing 100875, China
| | - Qiang Zhang
- School of Social Development and Public Policy, Beijing Normal University, Beijing 100875, China
- Correspondence: ; Tel.: +86-18500084200; Fax: +86-10-58800366
| | - Qibin Lu
- School of Social Development and Public Policy, Beijing Normal University, Beijing 100875, China
| | - Chengcheng Liu
- School of Social Development and Public Policy, Beijing Normal University, Beijing 100875, China
| | - Fangxin Yi
- School of Social Development and Public Policy, Beijing Normal University, Beijing 100875, China
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Rijnink A, Blake D, Groot S, Brough C. Accessing needle exchange services in disasters for remote areas of Aotearoa New Zealand. Harm Reduct J 2022; 19:145. [PMID: 36544156 PMCID: PMC9771773 DOI: 10.1186/s12954-022-00709-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 10/21/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Needle Exchange Programme (NEP) mobile outreach services in Aotearoa New Zealand distribute injecting equipment to people who inject drugs (PWID) living in remote regions. In disasters, continued access to such services is imperative for the health and wellbeing of PWID. Disasters can compound existing inequities, particularly in regions characterised by poor or limited infrastructure, smaller populations, and challenging socioeconomic conditions. To gain insight into the barriers that prevent access to NEP harm-reduction services and understand the needs of PWID prior to and during disasters, this study foregrounds the voices of PWID based on the West Coast of the South Island, Aotearoa New Zealand. METHODS This qualitative study applied an interpretive phenomenological analysis approach, where 14 PWID and one key NEP staff member took part in semi-structured interviews. The interviews provided the opportunity for participants to share their experiences and perspectives about accessing sterile drug-injecting equipment during disasters, including the four-week COVID-19 Level 4 lockdown in March 2020. In total five superordinate and 14 subordinate themes were identified from the interveiws. RESULTS This study focuses on four of the key themes that impacted accessibility to NEP services: infrastructural hazards and equipment costs; social capital and practical support from peers and key contact networks; social stigma in public locations, including NEP-based pharmacies and emergency centres; and potential solutions to NEP equipment accessibility as frequently suggested by participants. CONCLUSIONS Access to NEP services is essential during natural hazard and human-generated disasters, as such NEP mobile outreach services and disaster resilience efforts should focus on maintaining service continuity for PWID during adverse times. This study champions a needs-based, stigma free approach to inclusive harm-reduction and emergency management practices for groups with specific needs in a disaster context.
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Affiliation(s)
- Anne Rijnink
- grid.148374.d0000 0001 0696 9806School of Psychology, Massey University, Wellington, Aotearoa New Zealand
| | - Denise Blake
- grid.267827.e0000 0001 2292 3111School of Health, Te Herenga Waka-Victoria University of Wellington, Wellington, Aotearoa New Zealand
| | - Shiloh Groot
- grid.9654.e0000 0004 0372 3343School of Psychology, University of Auckland, Auckland, Aotearoa New Zealand
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Binny RN, Lustig A, Hendy SC, Maclaren OJ, Ridings KM, Vattiato G, Plank MJ. Real-time estimation of the effective reproduction number of SARS-CoV-2 in Aotearoa New Zealand. PeerJ 2022; 10:e14119. [PMID: 36275456 PMCID: PMC9583856 DOI: 10.7717/peerj.14119] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 09/04/2022] [Indexed: 01/21/2023] Open
Abstract
During an epidemic, real-time estimation of the effective reproduction number supports decision makers to introduce timely and effective public health measures. We estimate the time-varying effective reproduction number, Rt , during Aotearoa New Zealand's August 2021 outbreak of the Delta variant of SARS-CoV-2, by fitting the publicly available EpiNow2 model to New Zealand case data. While we do not explicitly model non-pharmaceutical interventions or vaccination coverage, these two factors were the leading drivers of variation in transmission in this period and we describe how changes in these factors coincided with changes in Rt . Alert Level 4, New Zealand's most stringent restriction setting which includes stay-at-home measures, was initially effective at reducing the median Rt to 0.6 (90% CrI 0.4, 0.8) on 29 August 2021. As New Zealand eased certain restrictions and switched from an elimination strategy to a suppression strategy, Rt subsequently increased to a median 1.3 (1.2, 1.4). Increasing vaccination coverage along with regional restrictions were eventually sufficient to reduce Rt below 1. The outbreak peaked at an estimated 198 (172, 229) new infected cases on 10 November, after which cases declined until January 2022. We continue to update Rt estimates in real time as new case data become available to inform New Zealand's ongoing pandemic response.
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Affiliation(s)
- Rachelle N. Binny
- Manaaki Whenua-Landcare Research, Lincoln, New Zealand,Te Pūnaha Matatini, Auckland, New Zealand
| | - Audrey Lustig
- Manaaki Whenua-Landcare Research, Lincoln, New Zealand,Te Pūnaha Matatini, Auckland, New Zealand
| | - Shaun C. Hendy
- Te Pūnaha Matatini, Auckland, New Zealand,Department of Physics, University of Auckland, Auckland, New Zealand
| | - Oliver J. Maclaren
- Department of Engineering Science, University of Auckland, Auckland, New Zealand
| | - Kannan M. Ridings
- Te Pūnaha Matatini, Auckland, New Zealand,Department of Physics, University of Auckland, Auckland, New Zealand
| | - Giorgia Vattiato
- Te Pūnaha Matatini, Auckland, New Zealand,Department of Physics, University of Auckland, Auckland, New Zealand,School of Mathematics and Statistics, University of Canterbury, Christchurch, New Zealand
| | - Michael J. Plank
- Te Pūnaha Matatini, Auckland, New Zealand,School of Mathematics and Statistics, University of Canterbury, Christchurch, New Zealand
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Global Excess Mortality during COVID-19 Pandemic: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2022; 10:vaccines10101702. [PMID: 36298567 PMCID: PMC9607451 DOI: 10.3390/vaccines10101702] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 09/29/2022] [Accepted: 10/10/2022] [Indexed: 11/19/2022] Open
Abstract
Background: Currently, reported COVID-19 deaths are inadequate to assess the impact of the pandemic on global excess mortality. All-cause excess mortality is a WHO-recommended index for assessing the death burden of COVID-19. However, the global excess mortality assessed by this index remains unclear. We aimed to assess the global excess mortality during the COVID-19 pandemic. Methods: We searched PubMed, EMBASE, and Web of Science for studies published in English between 1 January 2020, and 21 May 2022. Cross-sectional and cohort studies that reported data about excess mortality during the pandemic were included. Two researchers independently searched the published studies, extracted data, and assessed quality. The Mantel–Haenszel random-effects method was adopted to estimate pooled risk difference (RD) and their 95% confidence intervals (CIs). Results: A total of 79 countries from twenty studies were included. During the COVID-19 pandemic, of 2,228,109,318 individuals, 17,974,051 all-cause deaths were reported, and 15,498,145 deaths were expected. The pooled global excess mortality was 104.84 (95% CI 85.56–124.13) per 100,000. South America had the highest pooled excess mortality [134.02 (95% CI: 68.24–199.80) per 100,000], while Oceania had the lowest [−32.15 (95% CI: −60.53–−3.77) per 100,000]. Developing countries had higher excess mortality [135.80 (95% CI: 107.83–163.76) per 100,000] than developed countries [68.08 (95% CI: 42.61–93.55) per 100,000]. Lower middle-income countries [133.45 (95% CI: 75.10–191.81) per 100,000] and upper-middle-income countries [149.88 (110.35–189.38) per 100,000] had higher excess mortality than high-income countries [75.54 (95% CI: 53.44–97.64) per 100,000]. Males had higher excess mortality [130.10 (95% CI: 94.15–166.05) per 100,000] than females [102.16 (95% CI: 85.76–118.56) per 100,000]. The population aged ≥ 60 years had the highest excess mortality [781.74 (95% CI: 626.24–937.24) per 100,000]. Conclusions: The pooled global excess mortality was 104.84 deaths per 100,000, and the number of reported all-cause deaths was higher than expected deaths during the global COVID-19 pandemic. In South America, developing and middle-income countries, male populations, and individuals aged ≥ 60 years had a heavier excess mortality burden.
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Cassim S, Keelan TJ. A review of localised Māori community responses to Covid-19 lockdowns in Aotearoa New Zealand. ALTERNATIVE: AN INTERNATIONAL JOURNAL OF INDIGENOUS PEOPLES 2022; 19:42-50. [PMID: 36967812 PMCID: PMC10028440 DOI: 10.1177/11771801221124428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aotearoa New Zealand has been commended for the overarching effectiveness of its Covid-19 response. Yet, the lockdowns challenged the health of whānau Māori (Māori families) alongside their social, cultural and financial well-being. However, Māori have repeatedly demonstrated innovative means of resilience throughout the pandemic. This review aimed to document the local grassroots, community-level responses to Covid-19 lockdowns by Māori. Three sources for searching for evidence were used: academic, websites and media, and Māori community networks. A total of 18 records were reviewed. Four of these records comprised published academic literature, 13 comprised news, online and media articles, and one was a situation report. Findings were grouped into three categories: distributive networks, well-being and resource support. The findings of this review provide an exemplar for the strength of Māori leadership and agency, alongside value-driven holistic approaches to health and well-being that could positively impact the health of all.
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Affiliation(s)
- Shemana Cassim
- Te Ngira: Institute for Population Research, Division of Arts, Law, Psychology & Social Science, University of Waikato, New Zealand
- Te Kura Hinengaro Tangata School of Psychology, Massey University, New Zealand
| | - Teorongonui Josie Keelan
- Ngā Pae o te Māramatanga, New Zealand’s Māori Centre of Research Excellence, Waipapa Taumata Rau, University of Auckland, New Zealand
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13
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Hanney SR, Straus SE, Holmes BJ. Saving millions of lives but some resources squandered: emerging lessons from health research system pandemic achievements and challenges. Health Res Policy Syst 2022; 20:99. [PMID: 36088365 PMCID: PMC9464102 DOI: 10.1186/s12961-022-00883-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 06/27/2022] [Indexed: 12/15/2022] Open
Abstract
During the SARS-CoV-2 pandemic, astonishingly rapid research averted millions of deaths worldwide through new vaccines and repurposed and new drugs. Evidence use informed life-saving national policies including non-pharmaceutical interventions. Simultaneously, there was unprecedented waste, with many underpowered trials on the same drugs. We identified lessons from COVID-19 research responses by applying WHO's framework for research systems. It has four functions-governance, securing finance, capacity-building, and production and use of research-and nine components. Two linked questions focused the analysis. First, to what extent have achievements in knowledge production and evidence use built on existing structures and capacity in national health research systems? Second, did the features of such systems mitigate waste? We collated evidence on seven countries, Australia, Brazil, Canada, Germany, New Zealand, the United Kingdom and the United States, to identify examples of achievements and challenges.We used the data to develop lessons for each framework component. Research coordination, prioritization and expedited ethics approval contributed to rapid identification of new therapies, including dexamethasone in the United Kingdom and Brazil. Accelerated vaccines depended on extensive funding, especially through the Operation Warp Speed initiative in the United States, and new platforms created through long-term biomedical research capacity in the United Kingdom and, for messenger ribonucleic acid (mRNA) vaccines, in Canada, Germany and the United States. Research capacity embedded in the United Kingdom's healthcare system resulted in trial acceleration and waste avoidance. Faster publication of research saved lives, but raised challenges. Public/private collaborations made major contributions to vastly accelerating new products, available worldwide, though unequally. Effective developments of living (i.e. regularly updated) reviews and guidelines, especially in Australia and Canada, extended existing expertise in meeting users' needs. Despite complexities, effective national policy responses (less evident in Brazil, the United Kingdom and the United States) also saved lives by drawing on health research system features, including collaboration among politicians, civil servants and researchers; good communications; and willingness to use evidence. Comprehensive health research strategies contributed to success in research production in the United Kingdom and in evidence use by political leadership in New Zealand. In addition to waste, challenges included equity issues, public involvement and non-COVID research. We developed recommendations, but advocate studies of further countries.
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Affiliation(s)
- Stephen R Hanney
- Health Economics Research Group, Department of Health Sciences, Brunel University London, London, United Kingdom.
| | - Sharon E Straus
- St Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Bev J Holmes
- Michael Smith Health Research BC, Vancouver, BC, Canada
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14
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Howell BE, Potgieter PH. COVID-19 contact-tracing smartphone application usage-The New Zealand COVID Tracer experience. TELECOMMUNICATIONS POLICY 2022; 46:102386. [PMID: 35642178 PMCID: PMC9127129 DOI: 10.1016/j.telpol.2022.102386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/25/2022] [Accepted: 05/11/2022] [Indexed: 06/15/2023]
Abstract
Contact tracing has been a central pillar of the nonpharmaceutical health system response to the COVID-19 pandemic. Countries around the world have devoted unprecedented levels of resources to build up their testing and tracing capabilities, including the development and deployment of smartphone-based applications. Yet despite these nontrivial investments, the body of academic literature evaluating the effects of the smartphone-based applications remains scant and many apps have not delivered the promised benefits (Bano et al. 2021). We contribute to this body of empirical evidence by analysing data on uptake and usage of New Zealand's QR code-based application New Zealand COVID Tracer (NZCT). Our paper uses descriptive statistics and regression analysis to focus on the likelihood of an individual registering to use the application, the likelihood that a registered user will use the application to scan QR codes, and the extent of that usage, measured as the number of codes scanned daily. In addition, we take advantage of the "natural experiment" offered by the decision in August 2021 following the establishment of endemic community transmission of COVID-19 to make use of the application mandatory from 7 September 2021 to assess the effect of this policy on usage. We find that despite increasing numbers of individuals downloading the application over time, the number of active devices and scanning activity was very low, even when community outbreaks occurred (i.e. actual infection risk was higher). Mandating use (separate and distinct from increased infection risk) led to an increase in the number of scans in total via an increase in the number of active devices only.
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Affiliation(s)
- Bronwyn E Howell
- School of Management, Victoria University of Wellington, New Zealand
- Institute for Technology and Network Economics, United States
| | - Petrus H Potgieter
- Department of Decision Sciences, University of South Africa, Pretoria, South Africa
- Institute for Technology and Network Economics, United States
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15
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Serrano-Gallardo P, Manzano A, Pawson R. Non-pharmaceutical interventions during COVID-19 in the UK and Spain: a rapid realist review. OPEN RESEARCH EUROPE 2022; 2:52. [PMID: 37645319 PMCID: PMC10446037 DOI: 10.12688/openreseurope.14566.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/08/2022] [Indexed: 08/31/2023]
Abstract
The paper is located at the crossroads of two modern intellectual movements. The first, evidence-based policy, seeks to locate vital information that will inform and improve key policy decisions on such matters as population health, social welfare, and human wellbeing. The second, complexity theory, describes the nature of the social world and perceives human action as persistently adaptive and social institutions as incessantly self-transformative. The first assumes that policies and programmes can achieve sufficient control to meet specific and measurable objectives. The second assumes that social actions are sufficiently capricious so that the society never conforms to anyone's plans - even those of the most powerful. The unparalleled resources committed to control the unprecedented attack of the COVID-19 pandemic are the epitome of complexity. The long struggle to contain the virus thus constitutes an ideal test bed to investigate this paradigmatic split. The paper undertakes this mission - focusing specifically on the effectiveness non-pharmaceutical interventions and examining evidence from the UK and Spain.
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Affiliation(s)
| | - Ana Manzano
- School of Sociology and Social Policy, University of Leeds, Leeds, LS2 9JT, UK
| | - Ray Pawson
- School of Sociology and Social Policy, University of Leeds, Leeds, LS2 9JT, UK
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16
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Mahmoudnia A, Mehrdadi N, Golbabaei Kootenaei F, Rahmati Deiranloei M, Al-e-Ahmad E. Increased personal protective equipment consumption during the COVID-19 pandemic: An emerging concern on the urban waste management and strategies to reduce the environmental impact. JOURNAL OF HAZARDOUS MATERIALS ADVANCES 2022. [PMID: 37520796 PMCID: PMC9190174 DOI: 10.1016/j.hazadv.2022.100109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Personal protective equipments (PPEs) are essential protective products for individuals exposed to microorganism, toxic substances, and pathogens. However, the advent of the coronavirus pandemic generated a heavy demand for PPE, which has led to a rapid accumulation of plastic waste related to potentially infectious PPE in the urban waste stream. Mismanagement of these wastes can lead to subsequent environmental problems. This study estimates the daily consumption of facemasks, gloves, and daily medical waste generation during the SARs-CoV-2 pandemic in the selected 33 countries worldwide. The results indicate that China used the highest daily facemasks and gloves among these selected countries, followed by India, the US, Brazil, Indonesia, and Japan. Moreover, India is the first one in medical waste production, followed by the USA, Brazil, the United Kingdom, France, and Spain. The article also provides viable strategies and discusses the pros and cons of strategies to address the unprecedented generation of plastic waste material during the pandemic. This manuscript also encourages scientific communities and policymakers to pay exceptional attention to the pandemic's plastic waste.
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Lewis L, Tadi P, Veldsman A, Jhagroo J, Harrington C, McFaul M. Torn between two worlds: COVID, it's your fault. INTERNATIONAL JOURNAL OF INTERCULTURAL RELATIONS : IJIR 2022; 89:100-110. [PMID: 35755424 PMCID: PMC9212626 DOI: 10.1016/j.ijintrel.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 06/02/2022] [Accepted: 06/02/2022] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic has had a global reach, impacting each one of us to varying degrees. Research is emerging on the medical, educational, social, and psychological effects of this pandemic; however, little has appeared yet on the impact on immigrant acculturation. We are six higher education immigrant academics in New Zealand and our collaborative autoethnographic study reports on the disruption to our immigrant selves caused by COVID-19. We present findings from our narratives written at two different times: a reflection after the initial eight-week New Zealand lockdown from March to May 2020, and a second meta-reflection one year later. We also illustrate, in graph form, our perceived stress levels associated with being immigrants during COVID-19. The narratives describe strong emotions linked to transnational connections that bound us to loved ones at home in COVID-ravaged countries. While we describe a stronger sense of belonging to our new society, we also identify COVID-19 as a disruptor and interrupter of the acculturation process regardless of our length of settlement in New Zealand. We argue that the increased stress of COVID-19 has triggered an interruption or oscillation that has disrupted our acculturation trajectories, surfacing emotions of acculturative stress even for those well adapted to their new society. These findings may resonate with immigrants in similar contexts and circumstances.
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Affiliation(s)
- Lyn Lewis
- Auckland University of Technology, New Zealand
| | - Parisa Tadi
- Auckland University of Technology, New Zealand
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18
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Wilta F, Chong ALC, Selvachandran G, Kotecha K, Ding W. Generalized Susceptible-Exposed-Infectious-Recovered model and its contributing factors for analysing the death and recovery rates of the COVID-19 pandemic. Appl Soft Comput 2022; 123:108973. [PMID: 35572359 PMCID: PMC9091070 DOI: 10.1016/j.asoc.2022.108973] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/07/2022] [Accepted: 04/28/2022] [Indexed: 01/25/2023]
Abstract
COVID-19 is a highly contagious disease that has infected over 136 million people worldwide with over 2.9 million deaths as of 11 April 2021. In March 2020, the WHO declared COVID-19 as a pandemic and countries began to implement measures to control the spread of the virus. The spread and the death rates of the virus displayed dramatic differences among countries globally, showing that there are several factors affecting its spread and mortality. By utilizing the cumulative number of cases from John Hopkins University, the recovery rate, death rate, and the number of active, recovered, and death cases were simulated to analyse the trends and patterns within the chosen countries. 10 countries from 3 different case severity categories (high cases, medium cases, and low cases) and 5 continents (Asia, North America, South America, Europe, and Oceania) were studied. A generalized SEIR model which considers control measures such as isolation, and preventive measures such as vaccination is applied in this study. This model is able to capture not only the dynamics between the states, but also the time evolution of the states by using the fourth-order-Runge-Kutta process. This study found no significant patterns in the countries under the same case severity category, suggesting that there are other factors contributing to the pattern in these countries. One of the factors influencing the pattern in each country is the population's age. COVID-19 related deaths were found to be notably higher among older people, indicating that countries comprising of a larger proportion of older age groups have an increased risk of experiencing higher death rates. Tighter governmental control measures led to fewer infections and eventually reduced the number of death cases, while increasing the recovery rate, and early implementations were found to be far more effective in controlling the spread of the virus and produced better outcomes.
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Affiliation(s)
- Felin Wilta
- Department of Actuarial Science and Applied Statistics, Faculty of Business & Management, UCSI University, Jalan Menara Gading, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Allyson Li Chen Chong
- Department of Actuarial Science and Applied Statistics, Faculty of Business & Management, UCSI University, Jalan Menara Gading, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Ganeshsree Selvachandran
- Department of Actuarial Science and Applied Statistics, Faculty of Business & Management, UCSI University, Jalan Menara Gading, 56000 Cheras, Kuala Lumpur, Malaysia,Corresponding author
| | - Ketan Kotecha
- Symbiosis Centre for Applied Artificial Intelligence, Symbiosis International (Deemed University), Pune 412115, India
| | - Weiping Ding
- School of Information Science and Technology, Nantong University, Nantong 226019, PR China
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19
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Petrov A, Omisakin OM. Evaluating the Impacts of COVID-19 on Operations and Management of Community Centres: An Auckland, New Zealand Case Study. JOURNAL OF INFORMATION & KNOWLEDGE MANAGEMENT 2022. [DOI: 10.1142/s0219649222500186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study evaluates the impact of COVID-19 on the operations and management of Community Centres (CCs) in Auckland. This Coronavirus posed unprecedented challenges to the communities and public facilities here and in many other countries. To mitigate the pandemic outbreak, the New Zealand government adopted the so-called “go hard, go early” strategy, which put all of the country to strict self-isolation for 52 days [Baker et al. (2020). The Medical Journal of Australia, 213(5), 198–200.e1]. This research aims to explore what challenges some of Auckland’s CCs faced during COVID-19 lockdown and what management decisions were taken to operate the CCs during these periods effectively. The study was based principally on primary data collected from the managers and visitors of eight CCs across Auckland via semi-structured interviews and anonymous online surveys. With all the information gathered and generated through thematic, correlation and deductive analysis, the study produced a “road map” for management actions. This framework should enable CCs to better articulate decisions for more effective and safer operating during future pandemic outbreaks.
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Affiliation(s)
- Alexander Petrov
- Otago Polytechnic, Auckland International Campus, Auckland, New Zealand
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20
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Allen J, Uekusa S, Alpass FM. Longitudinal Cohort Study of Depression and Anxiety Among Older Informal Caregivers Following the Initial COVID-19 Pandemic Response in Aotearoa New Zealand. J Aging Health 2022; 34:653-665. [PMID: 35412393 PMCID: PMC9008474 DOI: 10.1177/08982643211052713] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Objectives To assess the impact of providing care and conditions of care on psychological wellbeing among older informal caregivers following the initial period of COVID-19 pandemic restrictions in Aotearoa New Zealand. Methods Data were from population-based cohorts of older adults participating in the 2020 Health, Work and Retirement longitudinal survey (n = 3839, 17.4% informal caregivers). Changes in symptoms of depression and anxiety over 2018–2020 surveys associated with sociodemographic factors, caregiving, cohabitation with the care recipient, assistance provided with activities of daily living, support in providing care, and opportunity cost of care were assessed. Results Increased depression, but not anxiety, was associated with providing informal care. Among caregivers, lower living standards and cohabitation were associated with increased depression. Lower living standards, unemployment, and lower help from friend/family networks were associated with increased anxiety. Discussion Economic hardship and social capital provide targets for supporting psychological wellbeing of older caregivers during periods of pandemic restrictions.
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Affiliation(s)
- Joanne Allen
- 6420Massey University, Palmerston North, New Zealand
| | - Shinya Uekusa
- 6420Massey University, Palmerston North, New Zealand
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21
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Zachreson C, Shearer FM, Price DJ, Lydeamore MJ, McVernon J, McCaw J, Geard N. COVID-19 in low-tolerance border quarantine systems: Impact of the Delta variant of SARS-CoV-2. SCIENCE ADVANCES 2022; 8:eabm3624. [PMID: 35394833 PMCID: PMC8993115 DOI: 10.1126/sciadv.abm3624] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 02/16/2022] [Indexed: 05/25/2023]
Abstract
In controlling transmission of coronavirus disease 2019 (COVID-19), the effectiveness of border quarantine strategies is a key concern for jurisdictions in which the local prevalence of disease and immunity is low. In settings like this such as China, Australia, and New Zealand, rare outbreak events can lead to escalating epidemics and trigger the imposition of large-scale lockdown policies. Here, we develop and apply an individual-based model of COVID-19 to simulate case importation from managed quarantine under various vaccination scenarios. We then use the output of the individual-based model as input to a branching process model to assess community transmission risk. For parameters corresponding to the Delta variant, our results demonstrate that vaccination effectively counteracts the pathogen's increased infectiousness. To prevent outbreaks, heightened vaccination in border quarantine systems must be combined with mass vaccination. The ultimate success of these programs will depend sensitively on the efficacy of vaccines against viral transmission.
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Affiliation(s)
- Cameron Zachreson
- School of Computing and Information Systems, The University of Melbourne, Parkville, Victoria, Australia
| | - Freya M. Shearer
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - David J. Price
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
- Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Michael J. Lydeamore
- Department of Econometrics and Business Statistics, Monash University, Clayton, Victoria, Australia
| | - Jodie McVernon
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
- Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- Victorian Infectious Diseases Laboratory Epidemiology Unit, Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - James McCaw
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
- Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- School of Mathematics and Statistics, The University of Melbourne, Parkville, Victoria, Australia
| | - Nicholas Geard
- School of Computing and Information Systems, The University of Melbourne, Parkville, Victoria, Australia
- Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
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22
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Wilson OWA, McEwen H, Kelly P, Richards J. Declines in Physical Activity among New Zealand Adults during the COVID-19 Pandemic: Longitudinal Analyses of Five Data Waves from Pre-Pandemic through April 2021. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074041. [PMID: 35409722 PMCID: PMC8998164 DOI: 10.3390/ijerph19074041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/19/2022] [Accepted: 03/22/2022] [Indexed: 12/07/2022]
Abstract
Insights specific to the impact of the COVID-19 pandemic on physical activity participation in New Zealand (NZ) is limited. The purpose of this study was to examine longitudinal changes in leisure-time physical activity from pre-pandemic through April 2021. Demographic characteristics (age, gender, ethnicity, deprivation, disability status) and numerous indicators of leisure-time physical activity participation were assessed in a cohort of NZ adults (n = 1854, 54.6% women) over five waves (pre-pandemic, April 2020, June 2020, September 2020, and April 2021). Repeat measures were completed for: proportion participating in any physical activity; proportion meeting aerobic physical activity recommendations; physical activity duration; number of physical activities. There was a significant (p < 0.05) decline in mean physical activity duration and number of activities during the initial lockdown period in April 2020, but the proportion participating in any physical activity and the proportion meeting physical activity recommendations remained stable. However, all four physical activity participation indicators were significantly (p < 0.05) below pre-pandemic levels in all subsequent waves. Considerable and sustained declines in NZ adult leisure-time physical activity participation were evident over the first year of the pandemic. As of April 2021, physical activity participation showed limited signs of recovering to pre-pandemic levels.
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Affiliation(s)
- Oliver W. A. Wilson
- Faculty of Health, Victoria University of Wellington, Wellington 6140, New Zealand;
| | | | - Paul Kelly
- Physical Activity for Health Research Centre, Institute of Sport, Physical Education and Health Sciences, Moray House School of Education and Sport, University of Edinburgh, Edinburgh EH8 8FF, UK;
| | - Justin Richards
- Faculty of Health, Victoria University of Wellington, Wellington 6140, New Zealand;
- Sport New Zealand, Wellington 6140, New Zealand;
- Correspondence:
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23
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The End of the Elimination Strategy: Decisive Factors towards Sustainable Management of COVID-19 in New Zealand. EPIDEMIOLGIA (BASEL, SWITZERLAND) 2022; 3:135-147. [PMID: 36417272 PMCID: PMC9620908 DOI: 10.3390/epidemiologia3010011] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/05/2022] [Accepted: 03/14/2022] [Indexed: 12/14/2022]
Abstract
New Zealand has long been praised for the effectiveness of its COVID-19 elimination strategy. It resulted in fewer COVID-19-related deaths, better economic recovery, and less stringent policy measures within its borders compared with other OECD countries, which opted for mitigation or suppression. However, since September 2021, the rising number of infections has not been contained anymore by the contact tracing and self-isolation system in place and the government has shifted towards a policy strategy similar to suppression to manage the crisis. In this case study, we analyse the factors that led the government to switch policy and discuss why elimination became unsustainable to manage the COVID-19 epidemic in New Zealand. Results showed that the socioeconomic and political factors, along with the appearance of new variants and a delayed vaccination program, were accountable for the switch in strategy. This switch allows the country to better adapt to the evolving nature of the disease and to address the social and economic repercussions of the first year of measures. Our conclusion does not disregard elimination as an appropriate initial strategy to contain this pandemic in the absence of a vaccine or treatment, but rather suggests that borders cannot remain closed for long periods of time without creating social, economical, and political issues.
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24
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Steyn N, Plank MJ, Binny RN, Hendy SC, Lustig A, Ridings K. A COVID-19 vaccination model for Aotearoa New Zealand. Sci Rep 2022; 12:2720. [PMID: 35177804 PMCID: PMC8854696 DOI: 10.1038/s41598-022-06707-5] [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] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 02/01/2022] [Indexed: 12/16/2022] Open
Abstract
We develop a mathematical model to estimate the effect of New Zealand's vaccine rollout on the potential spread and health impacts of COVID-19. The main purpose of this study is to provide a basis for policy advice on border restrictions and control measures in response to outbreaks that may occur during the vaccination roll-out. The model can be used to estimate the theoretical population immunity threshold, which represents a point in the vaccine rollout at which border restrictions and other controls could be removed and only small, occasional outbreaks would take place. We find that, with a basic reproduction number of 6, approximately representing the Delta variant of SARS-CoV-2, and under baseline vaccine effectiveness assumptions, reaching the population immunity threshold would require close to 100% of the total population to be vaccinated. Since this coverage is not likely to be achievable in practice, relaxing controls completely would risk serious health impacts. However, the higher vaccine coverage is, the more collective protection the population has against adverse health outcomes from COVID-19, and the easier it will become to control outbreaks. There remains considerable uncertainty in model outputs, in part because of the potential for the evolution of new variants. If new variants arise that are more transmissible or vaccine resistant, an increase in vaccine coverage will be needed to provide the same level of protection.
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Affiliation(s)
- Nicholas Steyn
- Te Pūnaha Matatini: the Centre for Complex Systems and Networks, Auckland, New Zealand
- Department of Physics, University of Auckland, Auckland, New Zealand
- School of Mathematics and Statistics, University of Canterbury, Christchurch, New Zealand
| | - Michael J Plank
- Te Pūnaha Matatini: the Centre for Complex Systems and Networks, Auckland, New Zealand.
- School of Mathematics and Statistics, University of Canterbury, Christchurch, New Zealand.
| | - Rachelle N Binny
- Te Pūnaha Matatini: the Centre for Complex Systems and Networks, Auckland, New Zealand
- Manaaki Whenua, Lincoln, New Zealand
| | - Shaun C Hendy
- Te Pūnaha Matatini: the Centre for Complex Systems and Networks, Auckland, New Zealand
- Department of Physics, University of Auckland, Auckland, New Zealand
| | - Audrey Lustig
- Te Pūnaha Matatini: the Centre for Complex Systems and Networks, Auckland, New Zealand
- Manaaki Whenua, Lincoln, New Zealand
| | - Kannan Ridings
- Te Pūnaha Matatini: the Centre for Complex Systems and Networks, Auckland, New Zealand
- Department of Physics, University of Auckland, Auckland, New Zealand
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25
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Bussell EH, Cunniffe NJ. Optimal strategies to protect a sub-population at risk due to an established epidemic. J R Soc Interface 2022; 19:20210718. [PMID: 35016554 PMCID: PMC8753150 DOI: 10.1098/rsif.2021.0718] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Epidemics can particularly threaten certain sub-populations. For example, for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the elderly are often preferentially protected. For diseases of plants and animals, certain sub-populations can drive mitigation because they are intrinsically more valuable for ecological, economic, socio-cultural or political reasons. Here, we use optimal control theory to identify strategies to optimally protect a ‘high-value’ sub-population when there is a limited budget and epidemiological uncertainty. We use protection of the Redwood National Park in California in the face of the large ongoing state-wide epidemic of sudden oak death (caused by Phytophthora ramorum) as a case study. We concentrate on whether control should be focused entirely within the National Park itself, or whether treatment of the growing epidemic in the surrounding ‘buffer region’ can instead be more profitable. We find that, depending on rates of infection and the size of the ongoing epidemic, focusing control on the high-value region is often optimal. However, priority should sometimes switch from the buffer region to the high-value region only as the local outbreak grows. We characterize how the timing of any switch depends on epidemiological and logistic parameters, and test robustness to systematic misspecification of these factors due to imperfect prior knowledge.
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Affiliation(s)
- Elliott H Bussell
- Department of Plant Sciences, University of Cambridge, Cambridge CB2 3EA, UK
| | - Nik J Cunniffe
- Department of Plant Sciences, University of Cambridge, Cambridge CB2 3EA, UK
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Mules TC, Swaminathan A, Hirschfeld E, Borichevsky G, Frampton C, Day AS, Gearry RB. The impact of disease activity on psychological symptoms and quality of life in patients with inflammatory bowel disease-results from the Stress, Anxiety and Depression with Disease Activity (SADD) Study. Aliment Pharmacol Ther 2022; 55:201-211. [PMID: 34587655 DOI: 10.1111/apt.16616] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 08/22/2021] [Accepted: 09/09/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Disease activity may be a risk factor for psychological illness in patients with inflammatory bowel disease (IBD). AIM To correlate objective measures of disease activity with psychological symptoms. METHODS Adult patients with IBD undergoing ileocolonoscopy were prospectively recruited. Demographic, psychological symptoms (depression, anxiety, stress), disease activity (symptoms, biomarkers, endoscopy), and quality of life (QoL) data were collected. One-way ANOVA and multivariable analyses examined the associations between disease activity and symptoms of psychological illness, and identified other predictors of mental illness and reduced QoL. RESULTS A total of 172 patients were included, 107 with Crohn's disease (CD) and 65 with ulcerative colitis (UC). There was no significant association between objective disease activity (endoscopic scores, faecal calprotectin or C-reactive protein) and depression, anxiety or stress scores (P > 0.05 for all comparisons). Gastrointestinal symptoms were significantly associated with symptoms of depression, anxiety and stress in patients with CD and UC (P < 0.05). On multivariable analysis, only gastrointestinal symptoms were associated with severe symptoms of depression (OR 20.78 [6.71-92.37], P < 0.001) and anxiety (OR 4.26 [1.70-12.25], P = 0.004). Anti-TNF and corticosteroid use, the presence of severe depressive, moderate-severe stress and gastrointestinal symptoms, and endoscopically active IBD were associated with a reduced QoL (P < 0.05). Longer duration of IBD predicted an improved QoL (P < 0.05). CONCLUSIONS Objective measures of disease activity are not associated with symptoms of psychological illness in patients with IBD. Clinicians should consider underlying mental illness in patients with IBD with active gastrointestinal symptoms.
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Affiliation(s)
- Thomas C Mules
- Christchurch Hospital, Canterbury District Health Board, Canterbury, New Zealand
| | - Akhilesh Swaminathan
- Christchurch Hospital, Canterbury District Health Board, Canterbury, New Zealand.,University of Otago, Christchurch, New Zealand
| | | | | | | | - Andrew S Day
- Christchurch Hospital, Canterbury District Health Board, Canterbury, New Zealand.,University of Otago, Christchurch, New Zealand
| | - Richard B Gearry
- Christchurch Hospital, Canterbury District Health Board, Canterbury, New Zealand.,University of Otago, Christchurch, New Zealand
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Morgan C, Tsai MC, Hsu CE, Chow HW, Guo HR, Lee MH. Qualitative impact assessment of COVID-19 on the pedagogical, technological and social experiences of higher education students in Taiwan. EDUCATION AND INFORMATION TECHNOLOGIES 2022; 27:10471-10495. [PMID: 35308642 PMCID: PMC8916930 DOI: 10.1007/s10639-022-10896-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 01/13/2022] [Indexed: 05/08/2023]
Abstract
COVID-19 has imposed a rippling effect on educational institutions globally, substantially impacting nearly 1.6 billion learners in more than 190 countries. Recognizing Taiwan as an atypicality during this crisis for suffering from a relatively moderate mortality/morbidity compared with the rest of the world, the present paper qualitatively explores the pedagogical, technological and social impact of COVID-19 on higher education students in Taiwan. Employing the focus group discussion methodology, we recruited a cohort of 23 students, comprising of 15 local and 8 international students. Findings show diverse pedagogical experiences in students' instructional modalities. Trending by either discipline of study, students from Science, Technology, Engineering and Mathematics disciplines expressed a greater preference for face-to-face instruction compared to their humanities counterparts. Distance learners reported a decrease in study efficacy and a lack of sense of belongingness to their university. All students demonstrated a high sense of perceived safety and reported minimal changes in their socializing norms during the pandemic. In terms of career planning, local students expressed minimal concerns about potential changes in their careers, versus international students who expressed high degrees of uncertainty, fear and pessimism in the same regard.
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Affiliation(s)
- Cyleen Morgan
- Institute of International Management, National Cheng Kung University, Tainan, Taiwan
| | - Meng-Che Tsai
- Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Chiehwen Ed Hsu
- Institute of International Management, National Cheng Kung University, Tainan, Taiwan
| | - Hsueh-Wen Chow
- Institute of Physical Education Health & Leisure Studies, National Cheng Kung University, Tainan, Taiwan
| | - How-Ran Guo
- Department of Environmental and Occupational Health, National Cheng Kung University, Tainan, Taiwan
- Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Meng-Hsueh Lee
- Cross College Elite Program, National Cheng Kung University, Tainan, Taiwan
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McNeill B, Gillon GT. Lockdown Experiences of 10-13 Year Olds in New Zealand. NEW ZEALAND JOURNAL OF EDUCATIONAL STUDIES 2021; 57:173-189. [PMID: 38624791 PMCID: PMC8715840 DOI: 10.1007/s40841-021-00237-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 12/22/2021] [Indexed: 11/29/2022]
Abstract
The implementation of lockdowns that include the closure of educational facilities for face to face teaching has been one of the strategies used internationally to contain the spread of the COVID-19 virus. Research suggests lockdowns are associated with negative impacts on children's psycho-social functioning, Most research, however, has been conducted in countries where extended lockdown periods have been in place and has primarily used parent/child survey to gain insight into lockdown effects. The current study was conducted in the context of New Zealand's initial 7-week national lockdown which allowed examination of the impact of a relatively short lockdown period. Participants (n = 139) aged 10 to 13 years from one school were interviewed face to face about their experiences during lockdown immediately following the re-opening of schools. Participants' self-concept was also evaluated to gain an understanding of their psycho-social skills after lockdown. Qualitative analysis identified positive and negative features of lockdown from children's perspectives. Analysis also focused on changes to children's relationships with close family members during lockdown. The findings have implications for identifying how to optimise lockdown experiences for children.
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Affiliation(s)
- Brigid McNeill
- School of Teacher Education, College of Education Health and Human Development, University of Canterbury, Private Bag 4800, Christchurch, 8140 New Zealand
- University of Canterbury Child Well-being Research Institute, College of Education Health and Human Development, University of Canterbury, Christchurch, New Zealand
- Better Start National Science Challenge, Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Gail T. Gillon
- University of Canterbury Child Well-being Research Institute, College of Education Health and Human Development, University of Canterbury, Christchurch, New Zealand
- Better Start National Science Challenge, Liggins Institute, University of Auckland, Auckland, New Zealand
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Mantzioris E, Weinstein P. Garlic as a vampire deterrent: fact or fiction? Med J Aust 2021; 215:541-543. [PMID: 34897727 DOI: 10.5694/mja2.51349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Evangeline Mantzioris
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA
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Nohl A, Ben Abdallah H, Weichert V, Zeiger S, Ohmann T, Dudda M. A Local Survey of COVID-19: Vaccine Potential Acceptance Rate among Personnel in a Level 1 Trauma Center without Severe COVID-19 Cases. Healthcare (Basel) 2021; 9:healthcare9121616. [PMID: 34946342 PMCID: PMC8701334 DOI: 10.3390/healthcare9121616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/15/2021] [Accepted: 11/18/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Healthcare workers (HCWs) in hospitals are at high risk during the COVID-19 pandemic. Healthcare workers' infection risk could be amplified during the ongoing pandemic due to various factors, including continuous exposure to patients and inadequate infection control training. Despite the risk healthcare workers face, vaccine hesitancy remains a global challenge. Differences in acceptance rates have ranged from less than 55% (in Russia) to nearly 90% (in China). In order to improve our knowledge of vaccine acceptance and its variation in rates, an evaluation is warranted. A survey was thus administered to healthcare workers. METHODS This survey aimed to address vaccination acceptance among employees in an urban level 1 trauma hospital. It was conducted through a developed and structured questionnaire that was randomly distributed online among the staff (age ≥18 years) to receive their feedback. RESULTS Among 285 participants (out of 995 employees), 69% were female, and 83.5% were overaged more than 30 years of age. The two largest groups were nurses (32%) and doctors (22%). The majority of respondents reported that they would "like to be vaccinated" (77.4%) and that they trusted the COVID-19 vaccine (62%). Moreover, 67.8% also reported that they felt the vaccination was effective. They reported that vaccination was a method to prevent the spread of COVID-19 (85.15%) and was a way to protect individuals with weak immune systems (78.2%). More importantly, the participants were concerned about other people (80.1%) and believed the vaccine would protect others. On the other hand, the result showed that the majority of participants (95.3%) chose to be vaccinated once everyone else was vaccinated, "I don't need to get vaccinated". Results showed that the majority of participants that chose "I don't need to get vaccinated" did so after everyone else was vaccinated. Our results show that COVID-19 vaccination intention in a level 1 trauma hospital was associated with older age males who are more confident, and also share a collective responsibility, are less complacent, and have fewer constraints. CONCLUSION Acceptance of the COVID-19 vaccine is relatively low among healthcare workers (HCWs). Differences in vaccine acceptance have been noted between different categories of HCWs and genders. Therefore, addressing barriers to vaccination acceptance among these HCWs is essential to avoid reluctance to receive the vaccination, but it will be challenging.
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Affiliation(s)
- André Nohl
- Department of Emergency Medicine, BG Klinikum Duisburg, 47249 Duisburg, Germany;
- Helicopter Emergency Medical Service (HEMS), 47249 Duisburg, Germany;
- Emergency Medical Services, Fire Brigade Oberhausen, 46047 Oberhausen, Germany
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Essen, 45147 Essen, Germany
- Correspondence: (A.N.); (M.D.)
| | - Heithem Ben Abdallah
- Research Department, BG Klinikum Duisburg, 47249 Duisburg, Germany; (H.B.A.); (T.O.)
| | - Veronika Weichert
- Helicopter Emergency Medical Service (HEMS), 47249 Duisburg, Germany;
- Department of Trauma Surgery, BG Klinikum Duisburg, 47249 Duisburg, Germany
| | - Sascha Zeiger
- Department of Emergency Medicine, BG Klinikum Duisburg, 47249 Duisburg, Germany;
- Helicopter Emergency Medical Service (HEMS), 47249 Duisburg, Germany;
- Emergency Medical Services, Fire Brigade Duisburg, 47058 Duisburg, Germany
| | - Tobias Ohmann
- Research Department, BG Klinikum Duisburg, 47249 Duisburg, Germany; (H.B.A.); (T.O.)
| | - Marcel Dudda
- Helicopter Emergency Medical Service (HEMS), 47249 Duisburg, Germany;
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Essen, 45147 Essen, Germany
- Department of Trauma Surgery, BG Klinikum Duisburg, 47249 Duisburg, Germany
- Emergency Medical Services, Fire Brigade Essen, 45139 Essen, Germany
- Correspondence: (A.N.); (M.D.)
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Islam N, Jdanov DA, Shkolnikov VM, Khunti K, Kawachi I, White M, Lewington S, Lacey B. Effects of covid-19 pandemic on life expectancy and premature mortality in 2020: time series analysis in 37 countries. BMJ 2021; 375:e066768. [PMID: 34732390 PMCID: PMC8564739 DOI: 10.1136/bmj-2021-066768] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/06/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To estimate the changes in life expectancy and years of life lost in 2020 associated with the covid-19 pandemic. DESIGN Time series analysis. SETTING 37 upper-middle and high income countries or regions with reliable and complete mortality data. PARTICIPANTS Annual all cause mortality data from the Human Mortality Database for 2005-20, harmonised and disaggregated by age and sex. MAIN OUTCOME MEASURES Reduction in life expectancy was estimated as the difference between observed and expected life expectancy in 2020 using the Lee-Carter model. Excess years of life lost were estimated as the difference between the observed and expected years of life lost in 2020 using the World Health Organization standard life table. RESULTS Reduction in life expectancy in men and women was observed in all the countries studied except New Zealand, Taiwan, and Norway, where there was a gain in life expectancy in 2020. No evidence was found of a change in life expectancy in Denmark, Iceland, and South Korea. The highest reduction in life expectancy was observed in Russia (men: -2.33, 95% confidence interval -2.50 to -2.17; women: -2.14, -2.25 to -2.03), the United States (men: -2.27, -2.39 to -2.15; women: -1.61, -1.70 to -1.51), Bulgaria (men: -1.96, -2.11 to -1.81; women: -1.37, -1.74 to -1.01), Lithuania (men: -1.83, -2.07 to -1.59; women: -1.21, -1.36 to -1.05), Chile (men: -1.64, -1.97 to -1.32; women: -0.88, -1.28 to -0.50), and Spain (men: -1.35, -1.53 to -1.18; women: -1.13, -1.37 to -0.90). Years of life lost in 2020 were higher than expected in all countries except Taiwan, New Zealand, Norway, Iceland, Denmark, and South Korea. In the remaining 31 countries, more than 222 million years of life were lost in 2020, which is 28.1 million (95% confidence interval 26.8m to 29.5m) years of life lost more than expected (17.3 million (16.8m to 17.8m) in men and 10.8 million (10.4m to 11.3m) in women). The highest excess years of life lost per 100 000 population were observed in Bulgaria (men: 7260, 95% confidence interval 6820 to 7710; women: 3730, 2740 to 4730), Russia (men: 7020, 6550 to 7480; women: 4760, 4530 to 4990), Lithuania (men: 5430, 4750 to 6070; women: 2640, 2310 to 2980), the US (men: 4350, 4170 to 4530; women: 2430, 2320 to 2550), Poland (men: 3830, 3540 to 4120; women: 1830, 1630 to 2040), and Hungary (men: 2770, 2490 to 3040; women: 1920, 1590 to 2240). The excess years of life lost were relatively low in people younger than 65 years, except in Russia, Bulgaria, Lithuania, and the US where the excess years of life lost was >2000 per 100 000. CONCLUSION More than 28 million excess years of life were lost in 2020 in 31 countries, with a higher rate in men than women. Excess years of life lost associated with the covid-19 pandemic in 2020 were more than five times higher than those associated with the seasonal influenza epidemic in 2015.
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Affiliation(s)
- Nazrul Islam
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Dmitri A Jdanov
- Max Planck Institute for Demographic Research, Rostock, Germany
- International Laboratory for Population and Health, National Research University Higher School of Economics, Moscow, Russian Federation
| | - Vladimir M Shkolnikov
- Max Planck Institute for Demographic Research, Rostock, Germany
- International Laboratory for Population and Health, National Research University Higher School of Economics, Moscow, Russian Federation
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
- NIHR Applied Research Collaboration-East Midlands, Leicester General Hospital, Leicester, UK
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Martin White
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Sarah Lewington
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK
- MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ben Lacey
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK
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Binny RN, Baker MG, Hendy SC, James A, Lustig A, Plank MJ, Ridings KM, Steyn N. Early intervention is the key to success in COVID-19 control. ROYAL SOCIETY OPEN SCIENCE 2021; 8:210488. [PMID: 34804563 PMCID: PMC8596003 DOI: 10.1098/rsos.210488] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/28/2021] [Indexed: 06/02/2023]
Abstract
New Zealand responded to the COVID-19 pandemic with a combination of border restrictions and an Alert Level (AL) system that included strict stay-at-home orders. These interventions were successful in containing an outbreak and ultimately eliminating community transmission of COVID-19 in June 2020. The timing of interventions is crucial to their success. Delaying interventions may reduce their effectiveness and mean that they need to be maintained for a longer period. We use a stochastic branching process model of COVID-19 transmission and control to simulate the epidemic trajectory in New Zealand's March-April 2020 outbreak and the effect of its interventions. We calculate key measures, including the number of reported cases and deaths, and the probability of elimination within a specified time frame. By comparing these measures under alternative timings of interventions, we show that changing the timing of AL4 (the strictest level of restrictions) has a far greater impact than the timing of border measures. Delaying AL4 restrictions results in considerably worse outcomes. Implementing border measures alone, without AL4 restrictions, is insufficient to control the outbreak. We conclude that the early introduction of stay-at-home orders was crucial in reducing the number of cases and deaths, enabling elimination.
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Affiliation(s)
- Rachelle N. Binny
- Manaaki Whenua, Lincoln, New Zealand
- Te Pūnaha Matatini: the Centre for Complex Systems and Networks, Auckland, New Zealand
| | - Michael G. Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, Auckland, New Zealand
| | - Shaun C. Hendy
- Department of Physics, University of Auckland, Auckland, New Zealand
- Te Pūnaha Matatini: the Centre for Complex Systems and Networks, Auckland, New Zealand
| | - Alex James
- School of Mathematics and Statistics, University of Canterbury, Christchurch, New Zealand
- Te Pūnaha Matatini: the Centre for Complex Systems and Networks, Auckland, New Zealand
| | - Audrey Lustig
- Manaaki Whenua, Lincoln, New Zealand
- Te Pūnaha Matatini: the Centre for Complex Systems and Networks, Auckland, New Zealand
| | - Michael J. Plank
- School of Mathematics and Statistics, University of Canterbury, Christchurch, New Zealand
- Te Pūnaha Matatini: the Centre for Complex Systems and Networks, Auckland, New Zealand
| | - Kannan M. Ridings
- Department of Physics, University of Auckland, Auckland, New Zealand
- Te Pūnaha Matatini: the Centre for Complex Systems and Networks, Auckland, New Zealand
| | - Nicholas Steyn
- School of Mathematics and Statistics, University of Canterbury, Christchurch, New Zealand
- Department of Physics, University of Auckland, Auckland, New Zealand
- Te Pūnaha Matatini: the Centre for Complex Systems and Networks, Auckland, New Zealand
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Jit M, Ananthakrishnan A, McKee M, Wouters OJ, Beutels P, Teerawattananon Y. Multi-country collaboration in responding to global infectious disease threats: lessons for Europe from the COVID-19 pandemic. THE LANCET REGIONAL HEALTH. EUROPE 2021; 9:100221. [PMID: 34642675 PMCID: PMC8495250 DOI: 10.1016/j.lanepe.2021.100221] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/29/2022]
Abstract
Since 2005, the world has faced several public health emergencies of international concern arising from infectious disease outbreaks. Of these, the COVID-19 pandemic has had by far the greatest health and economic consequences. During these emergencies, responses taken by one country often have an impact on other countries. The implication is that coordination between countries is likely to achieve better outcomes, individually and collectively, than each country independently pursuing its own self-interest. During the COVID-19 pandemic, gaps in multilateral cooperation on research and information sharing, vaccine development and deployment, and travel policies have hampered the speed and equity of global recovery. In this Health Policy article, we explore how multilateral collaboration between countries is crucial to successful responses to public health emergencies linked to infectious disease outbreaks. Responding to future global infectious disease threats and other health emergencies will require the creation of stronger mechanisms for multilateral collaboration before they arise. A change to the governance of multilateral institutions is a logical next step, with a focus on providing equal ownership and leadership opportunities to all member countries. Europe can be an example and advocate for stronger and better governed multilateral institutions.
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Affiliation(s)
- Mark Jit
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
- School of Public Health, University of Hong Kong, Hong Kong SAR, China
| | - Aparna Ananthakrishnan
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Thailand
| | - Martin McKee
- Department of Health Services and Policy, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Olivier J. Wouters
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Philippe Beutels
- Centre for Health Economic Research and Modelling Infectious Diseases, Vaccine & Infectious Diseases Institute, University of Antwerp, Antwerp, Belgium
- School of Public health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Yot Teerawattananon
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Thailand
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Chan OSK, Bradley KCF, Grioni A, Lau SKP, Li WT, Magouras I, Naing T, Padula A, To EMW, Tun HM, Tutt C, Woo PCY, Bloch R, Mauroo NF. Veterinary Experiences can Inform One Health Strategies for Animal Coronaviruses. ECOHEALTH 2021; 18:301-314. [PMID: 34542794 PMCID: PMC8450722 DOI: 10.1007/s10393-021-01545-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 05/24/2021] [Accepted: 07/12/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Olivia S K Chan
- LKS Faculty of Medicine, School of Public Health, Patrick Manson Building, The University of Hong Kong, Pokfulam, Hong Kong.
| | - Katriona C F Bradley
- Tai Wai Small Animal and Exotic Hospital, G/F, Lap Wo Building, 69-75 Chik Shun St, Tai Wai, NT, Hong Kong
| | - Alessandro Grioni
- Fauna Conservation Department, Kadoorie Farm and Botanic Garden, Lam Kam Road, Tai Po, NT, Hong Kong
| | - Susanna K P Lau
- Department of Microbiology, The University of Hong Kong, Room 26, 19/F, Block T, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, Hong Kong
| | - Wen-Ta Li
- Department of Pathology, Pangolin International Biomedical Consultant Ltd., Keelung, Taiwan
| | - Ioannis Magouras
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - Tint Naing
- Soares Avenue Paws and Claws Clinic, G/F No 29 - 33 Soares Avenue, Kowloon, Hong Kong
| | - Andrew Padula
- Australian Venom Research Unit, Department of Pharmacology, Faculty of Medicine, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Esther M W To
- Agriculture, Fisheries and Conservation Department, The Government of Hong Kong Special Administrative Region, Room 509, Cheung Sha Wan Government Offices, 303 Cheung Sha Wan Road, Sham Shui Po, Kowloon, Hong Kong
| | - Hein Min Tun
- LKS Faculty of Medicine, School of Public Health, Patrick Manson Building, The University of Hong Kong, Pokfulam, Hong Kong
| | - Cedric Tutt
- Cape Animal Dentistry Service, 78 Rosmead Avenue, Kenilworth, Cape Town, 7708, South Africa
| | - Patrick C Y Woo
- Department of Microbiology, The University of Hong Kong, Room 26, 19/F, Block T, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, Hong Kong
| | - Rebecca Bloch
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nathalie F Mauroo
- Hong Kong Wildlife Health Foundation, GPO Box 12585, Hong Kong, Hong Kong
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Clifford S, Quilty BJ, Russell TW, Liu Y, Chan YWD, Pearson CAB, Eggo RM, Endo A, Flasche S, Edmunds WJ. Strategies to reduce the risk of SARS-CoV-2 importation from international travellers: modelling estimations for the United Kingdom, July 2020. Euro Surveill 2021; 26:2001440. [PMID: 34596018 PMCID: PMC8485583 DOI: 10.2807/1560-7917.es.2021.26.39.2001440] [Citation(s) in RCA: 12] [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: 07/25/2020] [Accepted: 02/16/2021] [Indexed: 12/23/2022] Open
Abstract
BackgroundTo mitigate SARS-CoV-2 transmission risks from international air travellers, many countries implemented a combination of up to 14 days of self-quarantine upon arrival plus PCR testing in the early stages of the COVID-19 pandemic in 2020.AimTo assess the effectiveness of quarantine and testing of international travellers to reduce risk of onward SARS-CoV-2 transmission into a destination country in the pre-COVID-19 vaccination era.MethodsWe used a simulation model of air travellers arriving in the United Kingdom from the European Union or the United States, incorporating timing of infection stages while varying quarantine duration and timing and number of PCR tests.ResultsQuarantine upon arrival with a PCR test on day 7 plus a 1-day delay for results can reduce the number of infectious arriving travellers released into the community by a median 94% (95% uncertainty interval (UI): 89-98) compared with a no quarantine/no test scenario. This reduction is similar to that achieved by a 14-day quarantine period (median > 99%; 95% UI: 98-100). Even shorter quarantine periods can prevent a substantial amount of transmission; all strategies in which travellers spend at least 5 days (mean incubation period) in quarantine and have at least one negative test before release are highly effective (median reduction 89%; 95% UI: 83-95)).ConclusionThe effect of different screening strategies impacts asymptomatic and symptomatic individuals differently. The choice of an optimal quarantine and testing strategy for unvaccinated air travellers may vary based on the number of possible imported infections relative to domestic incidence.
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Affiliation(s)
- Samuel Clifford
- Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Billy J Quilty
- Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Timothy W Russell
- Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Yang Liu
- Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Yung-Wai D Chan
- Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Carl A B Pearson
- Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Rosalind M Eggo
- Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Akira Endo
- Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Stefan Flasche
- Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - W John Edmunds
- Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Perception of the Movement Control Order during the COVID-19 Pandemic: A Qualitative Study in Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168778. [PMID: 34444527 PMCID: PMC8394721 DOI: 10.3390/ijerph18168778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 12/02/2022]
Abstract
Malaysia implemented its first Movement Control Order (MCO) during the early phase of the COVID-19 pandemic to slow the transmission of the virus. This study aimed to explore the public perception of the MCO implementation and people’s experiences during this period. The study employed qualitative explorative in-depth interviews conducted with 23 Malaysian adults from various demographic backgrounds. Thematic analysis was performed using NVivo 12. Three main themes were identified: a period of information surge, heterogeneous emotional response, and attempts to adapt. During the MCO, the participants obtained information from multiple platforms. They suggested the need for clear and repeated instructions to avoid confusion and misinformation. They also acknowledged the importance of the MCO in breaking the chain of transmission and safeguarding high-risk groups; however, they also expressed that stricter enforcement from the authorities was warranted. The changes in the participants’ work–life routines, lack of physical interaction, and uncertainty about their health and the economy due to the MCO negatively impacted their psychological states. Despite these challenges, the participants attempted to adapt to life under the MCO in different ways. The findings imply that during a crisis, the public tends to seek clear and reliable information, experience emotional turmoil, and adapt to changes. The MCO implementation can be improved through an effective communication strategy and efforts to battle misinformation.
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Lane CR, Sherry NL, Porter AF, Duchene S, Horan K, Andersson P, Wilmot M, Turner A, Dougall S, Johnson SA, Sait M, Gonçalves da Silva A, Ballard SA, Hoang T, Stinear TP, Caly L, Sintchenko V, Graham R, McMahon J, Smith D, Leong LEX, Meumann EM, Cooley L, Schwessinger B, Rawlinson W, van Hal SJ, Stephens N, Catton M, Looker C, Crouch S, Sutton B, Alpren C, Williamson DA, Seemann T, Howden BP. Genomics-informed responses in the elimination of COVID-19 in Victoria, Australia: an observational, genomic epidemiological study. Lancet Public Health 2021; 6:e547-e556. [PMID: 34252365 PMCID: PMC8270762 DOI: 10.1016/s2468-2667(21)00133-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/26/2021] [Accepted: 06/01/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND A cornerstone of Australia's ability to control COVID-19 has been effective border control with an extensive supervised quarantine programme. However, a rapid recrudescence of COVID-19 was observed in the state of Victoria in June, 2020. We aim to describe the genomic findings that located the source of this second wave and show the role of genomic epidemiology in the successful elimination of COVID-19 for a second time in Australia. METHODS In this observational, genomic epidemiological study, we did genomic sequencing of all laboratory-confirmed cases of COVID-19 diagnosed in Victoria, Australia between Jan 25, 2020, and Jan 31, 2021. We did phylogenetic analyses, genomic cluster discovery, and integrated results with epidemiological data (detailed information on demographics, risk factors, and exposure) collected via interview by the Victorian Government Department of Health. Genomic transmission networks were used to group multiple genomic clusters when epidemiological and genomic data suggested they arose from a single importation event and diversified within Victoria. To identify transmission of emergent lineages between Victoria and other states or territories in Australia, all publicly available SARS-CoV-2 sequences uploaded before Feb 11, 2021, were obtained from the national sequence sharing programme AusTrakka, and epidemiological data were obtained from the submitting laboratories. We did phylodynamic analyses to estimate the growth rate, doubling time, and number of days from the first local infection to the collection of the first sequenced genome for the dominant local cluster, and compared our growth estimates to previously published estimates from a similar growth phase of lineage B.1.1.7 (also known as the Alpha variant) in the UK. FINDINGS Between Jan 25, 2020, and Jan 31, 2021, there were 20 451 laboratory-confirmed cases of COVID-19 in Victoria, Australia, of which 15 431 were submitted for sequencing, and 11 711 met all quality control metrics and were included in our analysis. We identified 595 genomic clusters, with a median of five cases per cluster (IQR 2-11). Overall, samples from 11 503 (98·2%) of 11 711 cases clustered with another sample in Victoria, either within a genomic cluster or transmission network. Genomic analysis revealed that 10 426 cases, including 10 416 (98·4%) of 10 584 locally acquired cases, diagnosed during the second wave (between June and October, 2020) were derived from a single incursion from hotel quarantine, with the outbreak lineage (transmission network G, lineage D.2) rapidly detected in other Australian states and territories. Phylodynamic analyses indicated that the epidemic growth rate of the outbreak lineage in Victoria during the initial growth phase (samples collected between June 4 and July 9, 2020; 47·4 putative transmission events, per branch, per year [1/years; 95% credible interval 26·0-85·0]), was similar to that of other reported variants, such as B.1.1.7 in the UK (mean approximately 71·5 1/years). Strict interventions were implemented, and the outbreak lineage has not been detected in Australia since Oct 29, 2020. Subsequent cases represented independent international or interstate introductions, with limited local spread. INTERPRETATION Our study highlights how rapid escalation of clonal outbreaks can occur from a single incursion. However, strict quarantine measures and decisive public health responses to emergent cases are effective, even with high epidemic growth rates. Real-time genomic surveillance can alter the way in which public health agencies view and respond to COVID-19 outbreaks. FUNDING The Victorian Government, the National Health and Medical Research Council Australia, and the Medical Research Future Fund.
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Affiliation(s)
- Courtney R Lane
- Microbiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Norelle L Sherry
- Microbiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Ashleigh F Porter
- Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Sebastian Duchene
- Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Kristy Horan
- Microbiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Patiyan Andersson
- Microbiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Mathilda Wilmot
- Microbiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | | | - Sally Dougall
- Victorian Department of Health, Melbourne, VIC, Australia
| | - Sandra A Johnson
- Microbiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Michelle Sait
- Microbiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Anders Gonçalves da Silva
- Microbiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia,Doherty Applied Microbial Genomics, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Susan A Ballard
- Microbiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Tuyet Hoang
- Microbiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Timothy P Stinear
- Doherty Applied Microbial Genomics, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia,Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Leon Caly
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Vitali Sintchenko
- Centre for Infectious Diseases and Microbiology Public Health, Westmead Hospital, Sydney, NSW, Australia,Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Rikki Graham
- Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Brisbane, QLD, Australia
| | - Jamie McMahon
- Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Brisbane, QLD, Australia
| | - David Smith
- Department of Microbiology, PathWest Laboratory Medicine, QEII Medical Centre, Perth, WA, Australia,School of Medicine, University of Western Australia, Perth, WA, Australia
| | - Lex EX Leong
- Public Health Laboratory, Microbiology and Infectious Diseases, SA Pathology, Adelaide, SA, Australia
| | - Ella M Meumann
- Territory Pathology, Royal Darwin Hospital, Darwin, NT, Australia,Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Louise Cooley
- Royal Hobart Hospital, Hobart, TAS, Australia,School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | | | - William Rawlinson
- Virology Research Laboratory, Serology and Virology Division, NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Sebastiaan J van Hal
- Department of Infectious Disease and Microbiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Nicola Stephens
- School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Mike Catton
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Clare Looker
- Victorian Department of Health, Melbourne, VIC, Australia
| | - Simon Crouch
- Victorian Department of Health, Melbourne, VIC, Australia
| | - Brett Sutton
- Victorian Department of Health, Melbourne, VIC, Australia
| | - Charles Alpren
- Victorian Department of Health, Melbourne, VIC, Australia
| | - Deborah A Williamson
- Microbiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia,Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia,Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia,Department of Microbiology, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Torsten Seemann
- Microbiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia,Doherty Applied Microbial Genomics, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Benjamin P Howden
- Microbiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia; Doherty Applied Microbial Genomics, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia; Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia.
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Wang MM, Fleßa S. Overcoming COVID-19 in China despite shortcomings of the public health system: what can we learn? HEALTH ECONOMICS REVIEW 2021; 11:25. [PMID: 34228254 PMCID: PMC8259095 DOI: 10.1186/s13561-021-00319-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 05/17/2021] [Indexed: 05/03/2023]
Abstract
BACKGROUND AND OBJECTIVE The COVID-19 pandemic started in Wuhan, China, in December 2019. Although there are some doubts about the reporting of cases and deaths in China, it seems that this country was able to control the epidemic more effectively than many other countries. In this paper, we would like to analyze the measures taken in China and compare them with other countries in order to find out what they can learn from China. METHODS We develop a system dynamics model of the COVID-19 pandemic in Wuhan. Based on a number of simulations we analyze the impact of changing parameters, such as contact rates, on the development of a second wave. RESULTS Although China's health care system seems to be poorly financed and inefficient, the epidemic was brought under control in a comparably short period of time and no second wave was experienced in Wuhan until today. The measures to contain the epidemic do not differ from what was implemented in other countries, but China applied them very early and rigorously. For instance, the consequent implementation of health codes and contact-tracking technology contributed to contain the disease and effectively prevented the second and third waves. CONCLUSIONS China's success in fighting COVID-19 is based on a very strict implementation of a set of measures, including digital management. While other countries discuss relaxing the lock-down at a rate of 50 per 100,000 inhabitants, China started local lock-downs at a rate of 3 per 100,000. We call for a public debate whether this policy would be feasible for more liberal countries as well.
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Al Attar WSA, Husain MA. Physiotherapists' knowledge and the implementation of COVID-19 infection prevention and control measures. Work 2021; 69:351-358. [PMID: 34092683 DOI: 10.3233/wor-210049] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Physiotherapists are required to recognize their role in managing patients with Coronavirus Disease-19 (COVID-19), and to adopt preventive measures to limit transmission of the disease. OBJECTIVE The aim of this study was to assess the perception, knowledge, and application of the preventive measures taken by physiotherapists in managing issues with confirmed or suspected patients suffering from COVID-19. METHODS A self-administered survey comprising 15 questions was divided into four sections related to precautions when interacting with patients with COVID-19: (1) knowledge of the physiotherapy role, (2) knowledge of preventive measures to limit transmission of the virus, (3) practicing these measures, and (4) managing patients with COVID-19. RESULTS A total of 456 physiotherapists from 139 countries participated in the study. Most physiotherapists were knowledgeable regarding their role in the management of COVID-19 patients (M = 94.3%; SD = 15.4) and the management of potential COVID-19 patients (M = 84.5%; SD = 20.1). The rating of knowledge and practices of preventive measures to limit transmission of COVID-19 were lower (M = 74.3%; SD = 25.7, and M = 62.5%; SD = 31.3, respectively). Participants from the European region (M = 83; SD = 15.8) had a higher score than participants from the Asia Western Pacific region (M = 78; SD = 18.49; P = 0.01). CONCLUSIONS Physiotherapists are highly knowledgeable about their role in managing COVID-19 patients. Most of them are adopting preventive measures to limit the transmission of the disease. Yet, physiotherapists are required to enroll in medical education, training and infection control workshops and courses to remain updated with the recent advances in such fields.
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Affiliation(s)
- Wesam Saleh A Al Attar
- Department of Physiotherapy, College of Applied Medical Sciences, Umm Al Qura University, Makkah, Saudi Arabia.,Discipline of Exercise and Sport Science, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, Australia.,Department of Sport, Exercise and Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Mohamed A Husain
- Department of Physiotherapy, College of Health and Sport Sciences, University of Bahrain, Manama, Bahrain
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Fang FC, Benson CA, del Rio C, Edwards KM, Fowler VG, Fredricks DN, Limaye AP, Murray BE, Naggie S, Pappas PG, Patel R, Paterson DL, Pegues DA, Petri WA, Schooley RT. COVID-19-Lessons Learned and Questions Remaining. Clin Infect Dis 2021; 72:2225-2240. [PMID: 33104186 PMCID: PMC7797746 DOI: 10.1093/cid/ciaa1654] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Indexed: 12/13/2022] Open
Abstract
In this article, the editors of Clinical Infectious Diseases review some of the most important lessons they have learned about the epidemiology, clinical features, diagnosis, treatment and prevention of SARS-CoV-2 infection and identify essential questions about COVID-19 that remain to be answered.
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Affiliation(s)
- Ferric C Fang
- Departments of Laboratory Medicine and Pathology, Microbiology, and Medicine, University of Washington School of Medicine, Seattle, WA USA
| | - Constance A Benson
- Department of Medicine, University of California, San Diego School of Medicine, San Diego, CA USA
| | - Carlos del Rio
- Departments of Medicine and Global Health, Emory University School of Medicine, Atlanta, GA USA
| | - Kathryn M Edwards
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN USA
| | - Vance G Fowler
- Department of Medicine, Duke University School of Medicine, Durham, NC USA
| | - David N Fredricks
- Department of Medicine, Fred Hutchinson Cancer Research Center, Seattle, WA USA
| | - Ajit P Limaye
- Departments of Laboratory Medicine and Pathology, Microbiology, and Medicine, University of Washington School of Medicine, Seattle, WA USA
| | - Barbara E Murray
- Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX USA
| | - Susanna Naggie
- Department of Medicine, Duke University School of Medicine, Durham, NC USA
| | - Peter G Pappas
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL USA
| | - Robin Patel
- Departments of Laboratory Medicine and Pathology, and Medicine, Mayo Clinic, Rochester, MN USA
| | - David L Paterson
- Department of Medicine, University of Queensland Centre for Clinical Research, Herston, QLD Australia
| | - David A Pegues
- Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
| | - William A Petri
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA USA
| | - Robert T Schooley
- Department of Medicine, University of California, San Diego School of Medicine, San Diego, CA USA
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Absence of Cryptosporidium hominis and dominance of zoonotic Cryptosporidium species in patients after Covid-19 restrictions in Auckland, New Zealand. Parasitology 2021; 148:1288-1292. [PMID: 34120663 PMCID: PMC8383192 DOI: 10.1017/s0031182021000974] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Coronavirus disease-2019 (Covid-19) nonpharmaceutical interventions have proven effective control measures for a range of respiratory illnesses throughout the world. These measures, which include isolation, stringent border controls, physical distancing and improved hygiene also have effects on other human pathogens, including parasitic enteric diseases such as cryptosporidiosis. Cryptosporidium infections in humans are almost entirely caused by two species: C. hominis, which is primarily transmitted from human to human, and Cryptosporidium parvum, which is mainly zoonotic. By monitoring Cryptosporidium species and subtype families in human cases of cryptosporidiosis before and after the introduction of Covid-19 control measures in New Zealand, we found C. hominis was completely absent after the first months of 2020 and has remained so until the beginning of 2021. Nevertheless, C. parvum has followed its typical transmission pattern and continues to be widely reported. We conclude that ~7 weeks of isolation during level 3 and 4 lockdown period interrupted the human to human transmission of C. hominis leaving only the primarily zoonotic transmission pathway used by C. parvum. Secondary anthroponotic transmission of C. parvum remains possible among close contacts of zoonotic cases. Ongoing 14-day quarantine measures for new arrivals to New Zealand have likely suppressed new incursions of C. hominis from overseas. Our findings suggest that C. hominis may be controlled or even eradicated through nonpharmaceutical interventions.
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Islam N, Shkolnikov VM, Acosta RJ, Klimkin I, Kawachi I, Irizarry RA, Alicandro G, Khunti K, Yates T, Jdanov DA, White M, Lewington S, Lacey B. Excess deaths associated with covid-19 pandemic in 2020: age and sex disaggregated time series analysis in 29 high income countries. BMJ 2021; 373:n1137. [PMID: 34011491 PMCID: PMC8132017 DOI: 10.1136/bmj.n1137] [Citation(s) in RCA: 214] [Impact Index Per Article: 71.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/29/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To estimate the direct and indirect effects of the covid-19 pandemic on mortality in 2020 in 29 high income countries with reliable and complete age and sex disaggregated mortality data. DESIGN Time series study of high income countries. SETTING Austria, Belgium, Czech Republic, Denmark, England and Wales, Estonia, Finland, France, Germany, Greece, Hungary, Israel, Italy, Latvia, Lithuania, the Netherlands, New Zealand, Northern Ireland, Norway, Poland, Portugal, Scotland, Slovakia, Slovenia, South Korea, Spain, Sweden, Switzerland, and United States. PARTICIPANTS Mortality data from the Short-term Mortality Fluctuations data series of the Human Mortality Database for 2016-20, harmonised and disaggregated by age and sex. INTERVENTIONS Covid-19 pandemic and associated policy measures. MAIN OUTCOME MEASURES Weekly excess deaths (observed deaths versus expected deaths predicted by model) in 2020, by sex and age (0-14, 15-64, 65-74, 75-84, and ≥85 years), estimated using an over-dispersed Poisson regression model that accounts for temporal trends and seasonal variability in mortality. RESULTS An estimated 979 000 (95% confidence interval 954 000 to 1 001 000) excess deaths occurred in 2020 in the 29 high income countries analysed. All countries had excess deaths in 2020, except New Zealand, Norway, and Denmark. The five countries with the highest absolute number of excess deaths were the US (458 000, 454 000 to 461 000), Italy (89 100, 87 500 to 90 700), England and Wales (85 400, 83 900 to 86 800), Spain (84 100, 82 800 to 85 300), and Poland (60 100, 58 800 to 61 300). New Zealand had lower overall mortality than expected (-2500, -2900 to -2100). In many countries, the estimated number of excess deaths substantially exceeded the number of reported deaths from covid-19. The highest excess death rates (per 100 000) in men were in Lithuania (285, 259 to 311), Poland (191, 184 to 197), Spain (179, 174 to 184), Hungary (174, 161 to 188), and Italy (168, 163 to 173); the highest rates in women were in Lithuania (210, 185 to 234), Spain (180, 175 to 185), Hungary (169, 156 to 182), Slovenia (158, 132 to 184), and Belgium (151, 141 to 162). Little evidence was found of subsequent compensatory reductions following excess mortality. CONCLUSION Approximately one million excess deaths occurred in 2020 in these 29 high income countries. Age standardised excess death rates were higher in men than women in almost all countries. Excess deaths substantially exceeded reported deaths from covid-19 in many countries, indicating that determining the full impact of the pandemic on mortality requires assessment of excess deaths. Many countries had lower deaths than expected in children <15 years. Sex inequality in mortality widened further in most countries in 2020.
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Affiliation(s)
- Nazrul Islam
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Vladimir M Shkolnikov
- Max Planck Institute for Demographic Research, Rostock, Germany
- International Laboratory for Population and Health, National Research University Higher School of Economics, Moscow, Russian Federation
| | - Rolando J Acosta
- Department of Biostatistics, Harvard T H Chan School of Public, Harvard University, Boston, MA, USA
| | - Ilya Klimkin
- International Laboratory for Population and Health, National Research University Higher School of Economics, Moscow, Russian Federation
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Rafael A Irizarry
- Department of Biostatistics, Harvard T H Chan School of Public, Harvard University, Boston, MA, USA
- Department of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Gianfranco Alicandro
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
- NIHR Applied Research Collaboration-East Midlands, Leicester General Hospital, Leicester, UK
| | - Tom Yates
- Diabetes Research Centre, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester, UK
| | - Dmitri A Jdanov
- Max Planck Institute for Demographic Research, Rostock, Germany
- International Laboratory for Population and Health, National Research University Higher School of Economics, Moscow, Russian Federation
| | - Martin White
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Sarah Lewington
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- MRC Population Heath Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ben Lacey
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Bradfield OM, Giubilini A. Spoonful of honey or a gallon of vinegar? A conditional COVID-19 vaccination policy for front-line healthcare workers. JOURNAL OF MEDICAL ETHICS 2021; 47:medethics-2020-107175. [PMID: 33975928 PMCID: PMC8257552 DOI: 10.1136/medethics-2020-107175] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/27/2021] [Accepted: 03/30/2021] [Indexed: 05/06/2023]
Abstract
Seven COVID-19 vaccines are now being distributed and administered around the world (figure correct at the time of submission), with more on the horizon. It is widely accepted that healthcare workers should have high priority. However, questions have been raised about what we ought to do if members of priority groups refuse vaccination. Using the case of influenza vaccination as a comparison, we know that coercive approaches to vaccination uptake effectively increase vaccination rates among healthcare workers and reduce patient morbidity if properly implemented. Using the principle of least restrictive alternative, we have developed an intervention ladder for COVID-19 vaccination policies among healthcare workers. We argue that healthcare workers refusing vaccination without a medical reason should be temporarily redeployed and, if their refusal persists after the redeployment period, eventually suspended, in order to reduce the risk to their colleagues and patients. This 'conditional' policy is a compromise between entirely voluntary or entirely mandatory policies for healthcare workers, and is consistent with healthcare workers' established professional, legal and ethical obligations to their patients and to society at large.
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Affiliation(s)
- Owen M Bradfield
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Alberto Giubilini
- Oxford Uehiro Centre for Practical Ethics & Wellcome Centre for Ethics and the Humanities, University of Oxford, Oxford, UK
- University of Oxford, Oxford, UK
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44
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Morris AM, Mintz JM. Une stratégie « sans autres vagues » pour la gestion de la COVID-19 au Canada. CMAJ 2021; 193:E502-E504. [PMID: 33824153 PMCID: PMC8049635 DOI: 10.1503/cmaj.202685-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Andrew M Morris
- Département de médecine (Morris), Système de santé Sinai, Réseau universitaire de santé, Université de Toronto, Ont.; École de politique publique (Mintz), Université de Calgary, Alb.
| | - Jack M Mintz
- Département de médecine (Morris), Système de santé Sinai, Réseau universitaire de santé, Université de Toronto, Ont.; École de politique publique (Mintz), Université de Calgary, Alb
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45
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Liou TG, Adler FR, Cahill BC, Cox DR, Cox JE, Grant GJ, Hanson KE, Hartsell SC, Hatton ND, Helms MN, Jensen JL, Kartsonaki C, Li Y, Leung DT, Marvin JE, Middleton EA, Osburn-Staker SM, Packer KA, Shakir SM, Sturrock AB, Tardif KD, Warren KJ, Waddoups LJ, Weaver LJ, Zimmerman E, Paine R. SARS-CoV-2 innate effector associations and viral load in early nasopharyngeal infection. Physiol Rep 2021; 9:e14761. [PMID: 33625796 PMCID: PMC7903990 DOI: 10.14814/phy2.14761] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/22/2021] [Accepted: 01/24/2021] [Indexed: 12/21/2022] Open
Abstract
COVID‐19 causes severe disease with poor outcomes. We tested the hypothesis that early SARS‐CoV‐2 viral infection disrupts innate immune responses. These changes may be important for understanding subsequent clinical outcomes. We obtained residual nasopharyngeal swab samples from individuals who requested COVID‐19 testing for symptoms at drive‐through COVID‐19 clinical testing sites operated by the University of Utah. We applied multiplex immunoassays, real‐time polymerase chain reaction assays and quantitative proteomics to 20 virus‐positive and 20 virus‐negative samples. ACE‐2 transcripts increased with infection (OR =17.4, 95% CI [CI] =4.78–63.8) and increasing viral N1 protein transcript load (OR =1.16, CI =1.10–1.23). Transcripts for two interferons (IFN) were elevated, IFN‐λ1 (OR =71, CI =7.07–713) and IFN‐λ2 (OR =40.2, CI =3.86–419), and closely associated with viral N1 transcripts (OR =1.35, CI =1.23–1.49 and OR =1.33 CI =1.20–1.47, respectively). Only transcripts for IP‐10 were increased among systemic inflammatory cytokines that we examined (OR =131, CI =1.01–2620). We found widespread discrepancies between transcription and translation. IFN proteins were unchanged or decreased in infected samples (IFN‐γ OR =0.90 CI =0.33–0.79, IFN‐λ2,3 OR =0.60 CI =0.48–0.74) suggesting viral‐induced shut‐off of host antiviral protein responses. However, proteins for IP‐10 (OR =3.74 CI =2.07–6.77) and several interferon‐stimulated genes (ISG) increased with viral load (BST‐1 OR =25.1, CI =3.33–188; IFIT1 OR =19.5, CI =4.25–89.2; IFIT3 OR =245, CI =15–4020; MX‐1 OR =3.33, CI =1.44–7.70). Older age was associated with substantial modifications of some effects. Ambulatory symptomatic patients had an innate immune response with SARS‐CoV‐2 infection characterized by elevated IFN, proinflammatory cytokine and ISG transcripts, but there is evidence of a viral‐induced host shut‐off of antiviral responses. Our findings may characterize the disrupted immune landscape common in patients with early disease.
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Affiliation(s)
- Theodore G Liou
- Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA.,Center for Quantitative Biology, University of Utah, Salt Lake City, UT, USA
| | - Frederick R Adler
- Center for Quantitative Biology, University of Utah, Salt Lake City, UT, USA.,Department of Mathematics and School of Biological Sciences, University of Utah, Salt Lake City, UT, USA
| | - Barbara C Cahill
- Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | | | - James E Cox
- Department of Biochemistry, School of Medicine, University of Utah, Salt Lake City, UT, USA.,Metabolomics, Proteomics and Mass Spectrometry Core, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Garett J Grant
- Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Kimberly E Hanson
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA.,Department of Pathology, University of Utah, Salt Lake City, UT, USA.,ARUP Laboratories, Salt Lake City, UT, USA
| | - Stephen C Hartsell
- Division of Emergency Medicine, Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | - Nathan D Hatton
- Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - My N Helms
- Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Judy L Jensen
- Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Christiana Kartsonaki
- Clinical Trial Service Unit & Epidemiological Studies Unit and Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yanping Li
- Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Daniel T Leung
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - James E Marvin
- Flow Cytometry Core Laboratory, University of Utah Health, Salt Lake City, UT, USA
| | - Elizabeth A Middleton
- Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Sandra M Osburn-Staker
- Metabolomics, Proteomics and Mass Spectrometry Core, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Kristyn A Packer
- Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Salika M Shakir
- Department of Pathology, University of Utah, Salt Lake City, UT, USA.,ARUP Laboratories, Salt Lake City, UT, USA
| | - Anne B Sturrock
- Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | | | - Kristi J Warren
- Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA.,Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Lindsey J Waddoups
- Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Lisa J Weaver
- Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Elizabeth Zimmerman
- Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Robert Paine
- Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA.,Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA
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Development and Characterization of Inhaled Ethanol as a Novel Pharmacological Strategy Currently Evaluated in a Phase II Clinical Trial for Early-Stage SARS-CoV-2 Infection. Pharmaceutics 2021; 13:pharmaceutics13030342. [PMID: 33808025 PMCID: PMC7999202 DOI: 10.3390/pharmaceutics13030342] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/26/2021] [Accepted: 03/02/2021] [Indexed: 12/15/2022] Open
Abstract
Inhaled administration of ethanol in the early stages of COVID-19 would favor its location on the initial replication sites, being able to reduce the progression of the disease and improving its prognosis. Before evaluating the efficacy and safety of this novel therapeutic strategy in humans, its characterization is required. The developed 65° ethanol formulation is stable at room temperature and protected from light for 15 days, maintaining its physicochemical and microbiological properties. Two oxygen flows have been tested for its administration (2 and 3 L/min) using an automated headspace gas chromatographic analysis technique (HS-GC-MS), with that of 2 L/min being the most appropriate one, ensuring the inhalation of an ethanol daily dose of 33.6 ± 3.6 mg/min and achieving more stable concentrations during the entire treatment (45 min). Under these conditions of administration, the formulation has proven to be safe, based on histological studies of the respiratory tracts and lungs of rats. On the other hand, these results are accompanied by the first preclinical molecular imaging study with radiolabeled ethanol administered by this route. The current ethanol formulation has received approval from the Spanish Agency of Medicines and Medical Devices for a phase II clinical trial for early-stage COVID-19 patients, which is currently in the recruitment phase (ALCOVID-19; EudraCT number: 2020-001760-29).
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47
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Lokuge K, Banks E, Davis S, Roberts L, Street T, O'Donovan D, Caleo G, Glass K. Exit strategies: optimising feasible surveillance for detection, elimination, and ongoing prevention of COVID-19 community transmission. BMC Med 2021; 19:50. [PMID: 33596902 PMCID: PMC7887417 DOI: 10.1186/s12916-021-01934-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 02/02/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Following implementation of strong containment measures, several countries and regions have low detectable community transmission of COVID-19. We developed an efficient, rapid, and scalable surveillance strategy to detect remaining COVID-19 community cases through exhaustive identification of every active transmission chain. We identified measures to enable early detection and effective management of any reintroduction of transmission once containment measures are lifted to ensure strong containment measures do not require reinstatement. METHODS We compared efficiency and sensitivity to detect community transmission chains through testing of the following: hospital cases; fever, cough and/or ARI testing at community/primary care; and asymptomatic testing; using surveillance evaluation methods and mathematical modelling, varying testing capacities, reproductive number (R) and weekly cumulative incidence of COVID-19 and non-COVID-19 respiratory symptoms using data from Australia. We assessed system requirements to identify all transmission chains and follow up all cases and primary contacts within each chain, per million population. RESULTS Assuming 20% of cases are asymptomatic and 30% of symptomatic COVID-19 cases present for testing, with R = 2.2, a median of 14 unrecognised community cases (8 infectious) occur when a transmission chain is identified through hospital surveillance versus 7 unrecognised cases (4 infectious) through community-based surveillance. The 7 unrecognised community upstream cases are estimated to generate a further 55-77 primary contacts requiring follow-up. The unrecognised community cases rise to 10 if 50% of cases are asymptomatic. Screening asymptomatic community members cannot exhaustively identify all cases under any of the scenarios assessed. The most important determinant of testing requirements for symptomatic screening is levels of non-COVID-19 respiratory illness. If 4% of the community have respiratory symptoms, and 1% of those with symptoms have COVID-19, exhaustive symptomatic screening requires approximately 11,600 tests/million population using 1/4 pooling, with 98% of cases detected (2% missed), given 99.9% sensitivity. Even with a drop in sensitivity to 70%, pooling was more effective at detecting cases than individual testing under all scenarios examined. CONCLUSIONS Screening all acute respiratory disease in the community, in combination with exhaustive and meticulous case and contact identification and management, enables appropriate early detection and elimination of COVID-19 community transmission. An important component is identification, testing, and management of all contacts, including upstream contacts (i.e. potential sources of infection for identified cases, and their related transmission chains). Pooling allows increased case detection when testing capacity is limited, even given reduced test sensitivity. Critical to the effectiveness of all aspects of surveillance is appropriate community engagement, messaging to optimise testing uptake and compliance with other measures.
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Affiliation(s)
- K Lokuge
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia.
| | - E Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - S Davis
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - L Roberts
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - T Street
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - D O'Donovan
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - G Caleo
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - K Glass
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
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48
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Lokuge K, Banks E, Davis S, Roberts L, Street T, O'Donovan D, Caleo G, Glass K. Exit strategies: optimising feasible surveillance for detection, elimination, and ongoing prevention of COVID-19 community transmission. BMC Med 2021; 19:50. [PMID: 33596902 DOI: 10.1101/2020.04.19.20071217] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 02/02/2021] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Following implementation of strong containment measures, several countries and regions have low detectable community transmission of COVID-19. We developed an efficient, rapid, and scalable surveillance strategy to detect remaining COVID-19 community cases through exhaustive identification of every active transmission chain. We identified measures to enable early detection and effective management of any reintroduction of transmission once containment measures are lifted to ensure strong containment measures do not require reinstatement. METHODS We compared efficiency and sensitivity to detect community transmission chains through testing of the following: hospital cases; fever, cough and/or ARI testing at community/primary care; and asymptomatic testing; using surveillance evaluation methods and mathematical modelling, varying testing capacities, reproductive number (R) and weekly cumulative incidence of COVID-19 and non-COVID-19 respiratory symptoms using data from Australia. We assessed system requirements to identify all transmission chains and follow up all cases and primary contacts within each chain, per million population. RESULTS Assuming 20% of cases are asymptomatic and 30% of symptomatic COVID-19 cases present for testing, with R = 2.2, a median of 14 unrecognised community cases (8 infectious) occur when a transmission chain is identified through hospital surveillance versus 7 unrecognised cases (4 infectious) through community-based surveillance. The 7 unrecognised community upstream cases are estimated to generate a further 55-77 primary contacts requiring follow-up. The unrecognised community cases rise to 10 if 50% of cases are asymptomatic. Screening asymptomatic community members cannot exhaustively identify all cases under any of the scenarios assessed. The most important determinant of testing requirements for symptomatic screening is levels of non-COVID-19 respiratory illness. If 4% of the community have respiratory symptoms, and 1% of those with symptoms have COVID-19, exhaustive symptomatic screening requires approximately 11,600 tests/million population using 1/4 pooling, with 98% of cases detected (2% missed), given 99.9% sensitivity. Even with a drop in sensitivity to 70%, pooling was more effective at detecting cases than individual testing under all scenarios examined. CONCLUSIONS Screening all acute respiratory disease in the community, in combination with exhaustive and meticulous case and contact identification and management, enables appropriate early detection and elimination of COVID-19 community transmission. An important component is identification, testing, and management of all contacts, including upstream contacts (i.e. potential sources of infection for identified cases, and their related transmission chains). Pooling allows increased case detection when testing capacity is limited, even given reduced test sensitivity. Critical to the effectiveness of all aspects of surveillance is appropriate community engagement, messaging to optimise testing uptake and compliance with other measures.
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Affiliation(s)
- K Lokuge
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia.
| | - E Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - S Davis
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - L Roberts
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - T Street
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - D O'Donovan
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - G Caleo
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - K Glass
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
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49
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Panneer S, Kantamaneni K, Pushparaj RRB, Shekhar S, Bhat L, Rice L. Multistakeholder Participation in Disaster Management-The Case of the COVID-19 Pandemic. Healthcare (Basel) 2021; 9:203. [PMID: 33668669 PMCID: PMC7918841 DOI: 10.3390/healthcare9020203] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/12/2021] [Accepted: 02/08/2021] [Indexed: 12/23/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is affecting society's health, economy, environment and development. COVID-19 has claimed many lives across the globe and severely impacted the livelihood of a considerable section of the world's population. We are still in the process of finding optimal and effective solutions to control the pandemic and minimise its negative impacts. In the process of developing effective strategies to combat COVID-19, different countries have adapted diverse policies, strategies and activities and yet there are no universal or comprehensive solutions to the problem. In this context, this paper brings out a conceptual model of multistakeholder participation governance as an effective model to fight against COVID-19. Accordingly, the current study conducted a scientific review by examining multi-stakeholder disaster response strategies, particularly in relation to COVID-19. The study then presents a conceptual framework for multistakeholder participation governance as one of the effective models to fight against COVID-19. Subsequently, the article offers strategies for rebuilding the economy and healthcare system through multi-stakeholder participation, and gives policy directions/decisions based on evidence to save lives and protect livelihoods. The current study also provides evidence about multidimensional approaches and multi-diplomatic mechanisms during the COVID-19 crisis, in order to examine dimensions of multi-stakeholder participation in disaster management and to document innovative, collaborative strategic directions across the globe. The current research findings highlight the need for global collaboration by working together to put an end to this pandemic situation through the application of a Multi-Stakeholder Spatial Decision Support System (MS-SDSS).
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Affiliation(s)
- Sigamani Panneer
- Department of Social Work, School of Social Sciences and Humanities and Centre for Happiness, Central University of Tamil Nadu, Thiruvarur, Tamilnadu 610005, India;
| | - Komali Kantamaneni
- Faculty of Creative Industries, Architecture and Engineering, Solent University, Southampton SO14 0YN, UK
- Department of Civil, Environmental & Geomatic Engineering, Chadwick Building, University College London (UCL), Gower St, London WC1E 6BT, UK
| | - Robert Ramesh Babu Pushparaj
- Research Scholar, Department of Social Work, Central University of Tamil Nadu, Thiruvarur, Tamilnadu 610005, India;
| | - Sulochana Shekhar
- Department of Geography, School of Earth Sciences, Central University of Tamil Nadu, Thiruvarur, Tamilnadu 610005, India;
| | - Lekha Bhat
- Department of Epidemiology & Public Health, School of Life Sciences, Central University of Tamil Nadu, Thiruvarur, Tamilnadu 610005, India;
| | - Louis Rice
- Centre for Architecture and Built Environment Research, University of the West of England, Bristol BS16 1QY, UK;
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50
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Elkhodr M, Mubin O, Iftikhar Z, Masood M, Alsinglawi B, Shahid S, Alnajjar F. Technology, Privacy, and User Opinions of COVID-19 Mobile Apps for Contact Tracing: Systematic Search and Content Analysis. J Med Internet Res 2021; 23:e23467. [PMID: 33493125 PMCID: PMC7879719 DOI: 10.2196/23467] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/14/2020] [Accepted: 01/20/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Many countries across the globe have released their own COVID-19 contact tracing apps. This has resulted in the proliferation of several apps that used a variety of technologies. With the absence of a standardized approach used by the authorities, policy makers, and developers, many of these apps were unique. Therefore, they varied by function and the underlying technology used for contact tracing and infection reporting. OBJECTIVE The goal of this study was to analyze most of the COVID-19 contact tracing apps in use today. Beyond investigating the privacy features, design, and implications of these apps, this research examined the underlying technologies used in contact tracing apps. It also attempted to provide some insights into their level of penetration and to gauge their public reception. This research also investigated the data collection, reporting, retention, and destruction procedures used by each of the apps under review. METHODS This research study evaluated 13 apps corresponding to 10 countries based on the underlying technology used. The inclusion criteria ensured that most COVID-19-declared epicenters (ie, countries) were included in the sample, such as Italy. The evaluated apps also included countries that did relatively well in controlling the outbreak of COVID-19, such as Singapore. Informational and unofficial contact tracing apps were excluded from this study. A total of 30,000 reviews corresponding to the 13 apps were scraped from app store webpages and analyzed. RESULTS This study identified seven distinct technologies used by COVID-19 tracing apps and 13 distinct apps. The United States was reported to have released the most contact tracing apps, followed by Italy. Bluetooth was the most frequently used underlying technology, employed by seven apps, whereas three apps used GPS. The Norwegian, Singaporean, Georgian, and New Zealand apps were among those that collected the most personal information from users, whereas some apps, such as the Swiss app and the Italian (Immuni) app, did not collect any user information. The observed minimum amount of time implemented for most of the apps with regard to data destruction was 14 days, while the Georgian app retained records for 3 years. No significant battery drainage issue was reported for most of the apps. Interestingly, only about 2% of the reviewers expressed concerns about their privacy across all apps. The number and frequency of technical issues reported on the Apple App Store were significantly more than those reported on Google Play; the highest was with the New Zealand app, with 27% of the reviewers reporting technical difficulties (ie, 10% out of 27% scraped reviews reported that the app did not work). The Norwegian, Swiss, and US (PathCheck) apps had the least reported technical issues, sitting at just below 10%. In terms of usability, many apps, such as those from Singapore, Australia, and Switzerland, did not provide the users with an option to sign out from their apps. CONCLUSIONS This article highlighted the fact that COVID-19 contact tracing apps are still facing many obstacles toward their widespread and public acceptance. The main challenges are related to the technical, usability, and privacy issues or to the requirements reported by some users.
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Affiliation(s)
- Mahmoud Elkhodr
- School of Engineering and Technology, Central Queensland University, Sydney, Australia
| | - Omar Mubin
- School of Computer, Data and Mathematical Sciences, Western Sydney University, Rydalmere, Australia
| | - Zainab Iftikhar
- Department of Computer Science, Syed Babar Ali School of Science and Engineering, Lahore University of Management Sciences, Lahore, Pakistan
| | - Maleeha Masood
- Department of Computer Science, Syed Babar Ali School of Science and Engineering, Lahore University of Management Sciences, Lahore, Pakistan
| | - Belal Alsinglawi
- School of Computer, Data and Mathematical Sciences, Western Sydney University, Rydalmere, Australia
| | - Suleman Shahid
- Department of Computer Science, Syed Babar Ali School of Science and Engineering, Lahore University of Management Sciences, Lahore, Pakistan
| | - Fady Alnajjar
- Department of Computer Science and Software Engineering, College of Information Technology, United Arab Emirates University, Alain, United Arab Emirates
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