It Didn't Have to be This Way: Reflections on the Ethical Justification of the Running Ban in Northern Italy in Response to the 2020 COVID-19 Outbreak

Unintended Consequences of COVID-19 Non-Pharmaceutical Interventions (NPIs) for Population Health and Health Inequalities

Since the start of the COVID-19 pandemic in early 2020, governments around the world have adopted an array of measures intended to control the transmission of the SARS-CoV-2 virus, using both pharmaceutical and non-pharmaceutical interventions (NPIs). NPIs are public health interventions that do not rely on vaccines or medicines and include policies such as lockdowns, stay-at-home orders, school closures, and travel restrictions. Although the intention was to slow viral transmission, emerging research indicates that these NPIs have also had unintended consequences for other aspects of public health. Hence, we conducted a narrative review of studies investigating these unintended consequences of NPIs, with a particular emphasis on mental health and on lifestyle risk factors for non-communicable diseases (NCD): physical activity (PA), overweight and obesity, alcohol consumption, and tobacco smoking. We reviewed the scientific literature using combinations of search terms such as 'COVID-19', 'pandemic', 'lockdowns', 'mental health', 'physical activity', and 'obesity'. NPIs were found to have considerable adverse consequences for mental health, physical activity, and overweight and obesity. The impacts on alcohol and tobacco consumption varied greatly within and between studies. The variability in consequences for different groups implies increased health inequalities by age, sex/gender, socioeconomic status, pre-existing lifestyle, and place of residence. In conclusion, a proper assessment of the use of NPIs in attempts to control the spread of the pandemic should be weighed against the potential adverse impacts on other aspects of public health. Our findings should also be of relevance for future pandemic preparedness and pandemic response teams.

One year of COVID-19 in Italy: are containment policies enough to shape the pandemic pattern?

A successful fight against COVID-19 greatly depends on citizens' adherence to the restrictive measures, which may not suffice alone. Making use of a containment index, data on sanctions, and Google's movement trends across Italian provinces, complemented by other sources, we investigate the extent to which compliance with the mobility limitations has affected the number of infections and deaths over time, for the period running from February 24, 2020 to February 23, 2021. We find proof of a deterrent effect on mobility given by the increase in sanction rate and positivity rate among the population. We also show how the pandemic dynamics have changed between the first and the second wave of the emergency. Lots of people could be spared by incorporating greater interventions and many more are at stake, despite the recent boost in vaccinations. Informing citizens about the effects and purposes of the restrictive measures has become increasingly important throughout the various phases of the pandemic.

La variante Delta del SARS-CoV-2: características e implicaciones para la salud pública en Colombia

La variante Delta del SARS-CoV-2 se ha convertido en uno de los mayores desafíos en salud pública a nivel mundial, ya que, luego de su identificación en la India en diciembre de 2020, se ha extendido de manera rápida, afectando principalmente a los países con bajas tasas de vacunación, y aquellos que han flexibilizado las medidas de salud pública establecidas para controlar la pandemia por COVID-19. La variante Delta tiene una mayor capacidad de replicación y se asocia con cargas virales hasta 1.260 veces más altas en comparación con las de infecciones causadas por la cepa original, lo cual puede estar asociado a mayores probabilidades de hospitalización, ingreso a UCI, necesidad de oxigenoterapia, neumonía, o incluso muerte. Las personas con vacunación completa cuentan con una protección casi similar contra las variantes Delta y Alfa. Dado el impacto de Delta en los países afectados en los que es la variante dominante, es necesario que todos los países desarrollen planes de acción sistemáticos enfocados en implementar estrictas medidas de salud pública y sociales en el contexto de la pandemia por COVID-19 y aumentar la cobertura de vacunación.. Teniendo en cuenta lo anterior, el objetivo de esta reflexión es describir las principales características de la variante Delta, su impacto en la dinámica de la pandemia en algunos de los países en que ha sido detectada, la efectividad de las vacunas contra esta variante, y sus implicaciones para la salud pública en Colombia.