Public health effects of travel-related policies on the COVID-19 pandemic: A mixed-methods systematic review

Comparison of emergency transport for acute alcohol intoxication before and after the coronavirus disease 2019 pandemic: A retrospective observational study

The ongoing coronavirus disease 2019 (COVID-19) pandemic has had a broad effect on social, economic, educational, and political systems. We investigated the effect of COVID-19 on emergency transportation due to acute alcohol intoxication in the Kochi Prefecture in Japan, a region with high alcohol consumption. This retrospective observational study was conducted using the data of 62,138 patients from the Kochi-Iryo-Net database, Kochi Prefecture's emergency medical and wide-area disaster information system. Chi-square tests and multiple logistic regression analyses were performed to examine the association between emergency transportation and alcohol intoxication. This analysis compared the monthly number of transportations during 2019 (as reference) with that throughout 2020 and 2021. Approximately 1.5 % of all emergency transportation cases were related to acute alcohol intoxication. The number of emergency transportation cases due to acute alcohol intoxication declined by 0.5 % in 2020 and 0.7 % in 2021 compared with that in 2019. Moreover, compared with that in 2019, the number of cases of emergency transportation due to acute alcohol intoxication significantly decreased in 2020 (incidence rate ratio: 0.78; 95 % confidence interval: 0.67-0.91) and 2021 (incidence rate ratio: 0.73; 95 % confidence interval: 0.63-0.86). Lifestyle changes due to the COVID-19 pandemic affected the number of emergency transports due to acute alcohol intoxication in 2020 and 2021 (during the COVID-19 pandemic) compared to that in 2019 (before the pandemic).

Scenario analysis of energy consumption and related emissions in the transportation industry-a case study of Shaanxi Province

In the context of pursuing carbon neutrality and balancing the use of fossil fuels with renewable energy, the transportation industry faces the challenge of accurately predicting energy demand, related emissions, and assessing the effectiveness of energy technologies and policies. This is crucial for formulating energy management plans and reducing carbon dioxide (CO2) and atmospheric pollutant emissions. Currently, research on energy consumption and emission forecasting primarily relies on energy consumption quantities and emission factors, which lack precision. This study employs the low emissions analysis platform (LEAP) model, utilizing a "bottom-up" modeling approach combined with scenario analysis to predict and analyze the energy demand and related emissions in the transportation industry. Compared to previous studies, the methodological framework proposed in this research offers higher precision and can explore energy-saving and emission-reduction pathways for different modes of transport, providing a valuable energy forecasting tool for transport policy formulation in other regions. The forecast results indicate that under the business-as-usual (BAU) scenario, by 2049, the energy consumption and related emissions in Shaanxi Province's transportation industry are expected to increase by 1.15 to 1.85 times compared to the baseline year. In the comprehensive (CP) scenario, the industry is projected to reach a carbon peak around 2033. The study also finds that energy consumption and emissions predominantly originate from private passenger vehicles, highway freight, and civil aviation passenger, which have the greatest potential for emission reduction under the transport structure optimized (TSO) scenario. Therefore, policymakers should consider regional development characteristics, combine different transportation modes, and specifically analyze the emission reduction potential of the transportation industry in various regions, formulating corresponding reduction policies accordingly.

Non-pharmaceutical interventions to reduce COVID-19 transmission in the UK: a rapid mapping review and interactive evidence gap map

BACKGROUND

Non-pharmaceutical interventions (NPIs) were crucial in the response to the COVID-19 pandemic, although uncertainties about their effectiveness remain. This work aimed to better understand the evidence generated during the pandemic on the effectiveness of NPIs implemented in the UK.

METHODS

We conducted a rapid mapping review (search date: 1 March 2023) to identify primary studies reporting on the effectiveness of NPIs to reduce COVID-19 transmission. Included studies were displayed in an interactive evidence gap map.

RESULTS

After removal of duplicates, 11 752 records were screened. Of these, 151 were included, including 100 modelling studies but only 2 randomized controlled trials and 10 longitudinal observational studies.Most studies reported on NPIs to identify and isolate those who are or may become infectious, and on NPIs to reduce the number of contacts. There was an evidence gap for hand and respiratory hygiene, ventilation and cleaning.

CONCLUSIONS

Our findings show that despite the large number of studies published, there is still a lack of robust evaluations of the NPIs implemented in the UK. There is a need to build evaluation into the design and implementation of public health interventions and policies from the start of any future pandemic or other public health emergency.

Does the resumption of international tourism heighten COVID-19 transmission?

Reopening countries also carries the risk of another wave of infections in many parts of the world, raising the question of whether we are ready to reopen our countries. This study examines the impact of reopening countries to receive foreign tourists on the spread of COVID-19 in 2022, encompassing 83 countries worldwide. We employ spatial quantile models capable of analyzing the spatial impact of tourism on the spread of the virus at different quantile levels. The research categorizes countries into three groups: low infection rate (10th-30th quantiles), moderate infection rate (40th-60th quantiles), and high infection rate (70th-90th quantiles). This allows for a more comprehensive and detailed comparison of the impacts. Additionally, considering the spatial dimension enables the explanation of both the direct and indirect effects of tourists on the country itself and neighboring countries. The findings reveal that the number of international tourists has a significant effect on the COVID-19 infection rate, particularly in countries with high initial infection rates. However, countries that effectively controlled their infection rates at a low level could maintain a low infection rate even after reopening to foreign tourists. It is also observed that reopening a country's borders negatively impacts the infection rate of neighboring countries. These important findings imply that governments of highly infected countries should shift their focus towards bolstering their economy by promoting domestic tourism and should delay reopening until the number of infections decreases.

COVID-19 vaccination coverage among travellers at Lomé international airport (Togo), in 2022

COVID-19 pandemic management leads to new health policies including the requirement of a vaccination pass or a negative Polymerase Chain Reaction (PCR) test for cross-border flights. The objective of this study was to estimate COVID-19 vaccination coverage among travellers, as well as factors associated with a full vaccination. A cross sectional study was conducted in July 2022 at the Gnassingbé Eyadema International Airport (LFW) in Lomé. Travellers met at LFW, aged 12 years or above, and who agreed to participate in the study have been submitted a questionnaire. Logistic regression analysis was performed to identify factors associated with full vaccination defined as having received at least two doses of COVID-19 vaccine according to a validated vaccine schedule. A total of 847 travellers were included. 67% were men The median age was 40 years, Interquartile Range [31-48]. The main health document presented by travellers was the vaccination pass (69.1%). The majority (84.4%) of travellers had received at least one dose of COVID-19 vaccine and 63.9% had received at least two doses. Being 40 years of age or above (aOR=1.42; P=0.046), and travelling from a country outside Africa (aOR=2.18, P=0.003), were positively associated with full vaccination. Vaccination coverage among travellers at the LFW was relatively high. Travellers from a region outside Africa and aged 40 years or above were more likely to be full vaccinated. Better communication and strengthening of the vaccination strategies in Africa could help reduce these gaps.

Quantifying Health Policy Uncertainty in China Using Newspapers: Text Mining Study

BACKGROUND

From the severe acute respiratory syndrome (SARS) outbreak in 2003 to the COVID-19 pandemic in 2019, a series of health measures and policies have been introduced from the central to the local level in China. However, no study has constructed an uncertainty index that can reflect the volatility, risk, and policy characteristics of the health environment.

OBJECTIVE

We used text mining analysis on mainstream newspapers to quantify the volume of reports about health policy and the total number of news articles and to construct a series of indexes that could reflect the uncertainty of health policy in China.

METHODS

Using the Wisenews database, 11 of the most influential newspapers in mainland China were selected to obtain the sample articles. The health policy uncertainty (HPU) index for each month from 2003 to 2022 was constructed by searching articles containing the specified keywords and calculating their frequency. Robustness tests were conducted through correlation analysis. The HPU index was plotted using STATA (version 16.0), and a comparative analysis of the China and US HPU indexes was then performed.

RESULTS

We retrieved 6482 sample articles from 7.49 million news articles in 11 newspapers. The China HPU index was constructed, and the robustness test showed a correlation coefficient greater than 0.74, which indicates good robustness. Key health events can cause index fluctuations. At the beginning of COVID-19 (May 2020), the HPU index climbed to 502.0. In December 2022, China's HPU index reached its highest value of 613.8 after the release of the "New Ten Rules" pandemic prevention and control policy. There were significant differences in HPU index fluctuations between China and the United States during SARS and COVID-19, as well as during the Affordable Care Act period.

CONCLUSIONS

National health policy is a guide for health development, and uncertainty in health policy can affect not only the implementation of policy by managers but also the health-seeking behavior of the people. Here, we conclude that changes in critical health policies, major national or international events, and infectious diseases with widespread impact can create significant uncertainty in China's health policies. The uncertainty of health policies in China and the United States is quite different due to different political systems and news environments. What is the same is that COVID-19 has brought great policy volatility to both countries. To the best of our knowledge, our work is the first systematic text mining study of HPU in China.

Effectiveness of international border control measures during the COVID-19 pandemic: a narrative synthesis of published systematic reviews

The effectiveness of international border control measures during the COVID-19 pandemic is not well understood. Using a narrative synthesis approach to published systematic reviews, we synthesized the evidence from both modelling and observational studies on the effects of border control measures on domestic transmission of the virus. We find that symptomatic screening measures were not particularly effective, but that diagnostic-based screening methods were more effective at identifying infected travellers. Targeted travel restrictions levied against travellers from Wuhan were likely temporarily effective but insufficient to stop the exportation of the virus to the rest of the world. Quarantine of inbound travellers was also likely effective at reducing transmission, but only with relatively long quarantine periods, and came with important economic and social effects. There is little evidence that most travel restrictions, including border closure and those implemented to stop the introduction of new variants of concern, were particularly effective. Border control measures played an important role in former elimination locations but only when coupled with strong domestic public health measures. In future outbreaks, if border control measures are to be adopted, they should be seen as part of a broader strategy that includes other non-pharmaceutical interventions. This article is part of the theme issue 'The effectiveness of non-pharmaceutical interventions on the COVID-19 pandemic: the evidence'.

Modelling the effect of travel-related policies on disease control in a meta-population structure

Travel restrictions, while delaying the spread of an emerging disease from the source, could inflict substantial socioeconomic burden. Travel-related policies, such as quarantine and testing of travelers, may be considered as alternative strategies to mitigate the negative impact of travel bans. We developed a meta-population, delay-differential model to evaluate a strategy that combines testing of travelers prior to departure from the source of infection with quarantine and testing at exit from quarantine in the destination population. Our results, based on early parameter estimates of SARS-CoV-2 infection, indicate that testing travelers at exit from quarantine is more effective in delaying case importation than testing them before departure or upon arrival. We show that a 1-day quarantine with an exit test could outperform a longer, 3-day quarantine without testing in delaying the outbreak peak. Rapid, large-scale testing capacities with short turnaround times provide important means of detecting infectious cases and reducing case importation, while shortening quarantine duration for travelers at destination.

Impacts of public health and social measures on COVID-19 in Europe: a review and modified Delphi technique

Introduction

The emergence of the COVID-19 pandemic in early 2020 led countries to implement a set of public health and social measures (PHSMs) attempting to contain the spread of the SARS-CoV-2 virus. This study aims to review the existing literature regarding key results of the PHSMs that were implemented, and to identify the PHSMs considered to have most impacted the epidemiological curve of COVID-19 over the last years during different stages of the pandemic.

Methods

The PHSM under study were selected from the Oxford COVID-19 Government Response Tracker (OxCGRT), supplemented by topics presented during the Rapid Exchange Forum (REF) meetings in the scope of the Population Health Information Research Infrastructure (PHIRI) project (H2020). The evidence- based review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to identify which reviews have already been published about each PHSMs and their results. In addition, two modified Delphi panel surveys were conducted among subject matter experts from 30 European countries to uphold the results found.

Results

There were 3,212 studies retrieved from PubMed, 162 full texts assessed for eligibility and 35 included in this PHSMs summary. The measures with clearest evidence on their positive impact from the evidence-based review include social distancing, hygiene measures, mask measures and testing policies. From the modified Delphi panel, the PHSMs considered most significant in the four periods analyzed were case isolation at home, face coverings, testing policy, and social distancing, respectively.

Discussion

The evidence found has significant implications for both researchers and policymakers. The study of PHSMs' impact on COVID-19 illustrates lessons learned for future pan- and epidemics, serving as a contribution to the health systems resilience discussion. These lessons, drawn from both the available scientific evidence and the perspectives of relevant subject matter experts, should also be considered in educational and preparedness programs and activities in the public health space.

Healthcare utilisation in patients with long-term conditions during the COVID-19 pandemic: a population-based observational study of all patients across Greater Manchester, UK

OBJECTIVES

Data on population healthcare utilisation (HCU) across both primary and secondary care during the COVID-19 pandemic are lacking. We describe primary and secondary HCU stratified by long-term conditions (LTCs) and deprivation, during the first 19 months of COVID-19 pandemic across a large urban area in the UK.

DESIGN

A retrospective, observational study.

SETTING

All primary and secondary care organisations that contributed to the Greater Manchester Care Record throughout 30 December 2019 to 1 August 2021.

PARTICIPANTS

3 225 169 patients who were registered with or attended a National Health Service primary or secondary care service during the study period.

PRIMARY OUTCOMES

Primary care HCU (incident prescribing and recording of healthcare information) and secondary care HCU (planned and unplanned admissions) were assessed.

RESULTS

The first national lockdown was associated with reductions in all primary HCU measures, ranging from 24.7% (24.0% to 25.5%) for incident prescribing to 84.9% (84.2% to 85.5%) for cholesterol monitoring. Secondary HCU also dropped significantly for planned (47.4% (42.9% to 51.5%)) and unplanned admissions (35.3% (28.3% to 41.6%)). Only secondary care had significant reductions in HCU during the second national lockdown. Primary HCU measures had not recovered to prepandemic levels by the end of the study. The secondary admission rate ratio between multi-morbid patients and those without LTCs increased during the first lockdown by a factor of 2.40 (2.05 to 2.82; p<0.001) for planned admissions and 1.25 (1.07 to 1.47; p=0.006) for unplanned admissions. No significant changes in this ratio were observed in primary HCU.

CONCLUSION

Major changes in primary and secondary HCU were observed during the COVID-19 pandemic. Secondary HCU reduced more in those without LTCs and the ratio of utilisation between patients from the most and least deprived areas increased for the majority of HCU measures. Overall primary and secondary care HCU for some LTC groups had not returned to prepandemic levels by the end of the study.

Exploring homesickness among international students in China during border closure

It is nearly three years since the World Health Organization (WHO) declared the COVID-19 crisis as a pandemic. Since its inception, border closures have been subscribed to by many countries as an extreme policy tool to curb the rate of infection amid emerging variants. China, one of the earliest countries to implement this measure just opened its borders to international students for inbound and outbound travel with several preconditions. Homesickness, a grave discomfort because of its cognitive hallmark of destabilizing the affective states and routine activities of individuals has been underexplored in many studies on the COVID-19 impact on education. This phenomenological study is the first to explore the level of border-closure-induced homesickness among international students in an Asian context (China). International students (n = 20) sampled from five universities in China were interviewed on how the COVID-19-engineered border closures have prompted homesickness among them and their development of coping skills. The thirteen (13) themes that emerged from the study suggest that the students suffered from somatic and psychological symptoms of homesickness. The social and academic life of students were negatively affected. Participants in the study relied on frequent phone calls, entertainment, and indoor and outdoor activities such as exercise and campus excursions as coping strategies against homesickness. It is advocated that higher education leaders in China put in measures to hasten the acculturation of international students to minimize their homesickness. Further research areas such as taking a keen focus on maladaptive symptoms of homesickness are also discussed.

Wastewater-based monitoring of SARS-CoV-2 at UK airports and its potential role in international public health surveillance

It is well established that air travel plays a key role in the global spread of many enteric and respiratory diseases, including COVID-19. Even with travel restrictions (e.g. mask wearing, negative COVID-19 test prior to departure), SARS-CoV-2 may be transmitted by asymptomatic or pre-symptomatic individuals carrying the virus. Due to the limitation of current clinical surveillance approaches, complementary methods need to be developed to allow estimation of the frequency of SARS-CoV-2 entry across international borders. Wastewater-based epidemiology (WBE) represents one such approach, allowing the unbiased sampling of SARS-CoV-2 carriage by passenger cohorts entering via airports. In this study, we monitored sewage in samples from terminals (n = 150) and aircraft (n = 32) at three major international airports in the UK for 1-3 weeks in March 2022. As the raw samples were more turbid than typical municipal wastewater, we used beef extract treatment followed by polyethylene glycol (PEG) precipitation to concentrate viruses, followed by reverse transcription quantitative PCR (RT-qPCR) for the detection of SARS-CoV-2 and a faecal indicator virus, crAssphage. All samples taken from sewers at the arrival terminals of Heathrow and Bristol airports, and 85% of samples taken from sites at Edinburgh airport, were positive for SARS-CoV-2. This suggests a high COVID-19 prevalence among passengers and/or airport staff members. Samples derived from aircraft also showed 93% SARS-CoV-2 positivity. No difference in viral prevalence was found before and after COVID-19 travel restrictions were lifted. Our results suggest that WBE is a useful tool for monitoring the global transfer rate of human pathogens and other disease-causing agents across international borders and should form part of wider international efforts to monitor and contain the spread of future disease outbreaks.

Exploring quality of life in Australian adults during a pandemic

Many aspects of society changed due to the COVID-19 pandemic. As a result, many individuals experienced the introduction of travel bans and restrictions, COVID-19 related anxiety, greater risk to their health and an increased need for adaptive coping. Research has shown health-related quality of life was negatively affected during the time. However, the influence that these restrictions and experiences had on other various quality of life domains (physical, psychological, environmental, and social) is not yet known. Therefore, we aimed to examine the relationships between COVID-19-related variables, health variables, psychological variables and five domains of quality of life in Australian adults. Data was collected via cross-sectional online surveys from 264 Australian participants (M age = 29.76 years, SD = 12.40). Five hierarchical multiple regression analyses were conducted. The findings showed better adaptive coping, decreased COVID-19 anxiety, and lower perceived health risk were all associated with better quality of life during this time. Neither having travel plans during 2020-2021 nor engaging in compensatory behaviours were associated with quality of life. During times of uncertainty, such as pandemics, natural disasters or war, providing anxiety-reducing coping strategies may be beneficial for reducing the negative impacts on quality of life. In line with these findings and similar research, we have provided several directions and recommendations for governments and media organisations for when future events, similar to COVID-19, occur.

No evidence for added value of introducing mandatory COVID-19 testing for international travellers entering Norway with a valid EU digital COVID certificate

BACKGROUND

As a response to the emergence of the new Omicron SARS-CoV-2 variant, on December 3, 2021, mandatory testing after entry to Norway was extended to include international travellers with a valid COVID-19 certificate. We aim to validate if mandatory testing upon arrival increased the proportion of travellers confirmed with a positive COVID-19 test after entry.

METHODS

We used individual level data on registered travellers linked with data on COVID-19 testing and confirmed COVID-19 cases. The proportions of confirmed cases among international travellers before and after the requirement were introduced was analysed with an interrupted times series design.

RESULTS

The proportion of travellers with an EU COVID-19 certificate tested at an official test station increased from 3% to 43% after mandatory testing was introduced. However, the proportion of all travellers confirmed with COVID-19 rose only marginally with 0.14 percentage point directly after the intervention (p-value .06). The results are limited by the absence of data on antigen tests taken by the traveller at home and missing data from travellers without a valid Norwegian ID.

CONCLUSIONS

Our findings suggest that the benefit of mandatory testing of all international travellers to Norway was marginal in the period directly after the emergence of the omicron variant. This result must be understood in the context of free of charge testing at official test centres, a government recommendation on a low threshold to test when experiencing symptoms in addition to limited surveillance of the compliance of the test after arrival requirement.

Spatial mobility patterns and COVID‐19 incidence: A regional analysis of the second wave in the Netherlands

A key policy measure introduced by governments worldwide at the beginning of the coronavirus disease 2019 (COVID‐19) pandemic was to restrict travel, highlighting the importance of people's mobility as one of the key contributors to spreading severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). However, there was little consistency regarding the geographical scale or the severity of these measures. Little use was made of commuting and travel data to inform decisions on when, where and at what level restrictions should be applied. We aim to contribute to regional policy by providing evidence that could be used to inform future policy debates on the most effective travel restrictions to impose during a pandemic. We present an analysis of the impact of mobility between municipalities on COVID‐19 incidence in the Netherlands. We used multiple linear regression models and geographical information systems to gain insight into the association between mobility‐related factors and demographic, socio‐economic and geographical factors with COVID‐19 incidence in municipalities. Our results indicate that spatial mobility patterns, when combined with COVID‐19 incidence in municipalities of origin, were associated with increased COVID‐19 incidence in municipalities of destination. In addition, various regional characteristics were associated with municipal incidence. By conducting our analyses over three different periods, we highlight the importance of time for COVID‐19 incidence. In the light of ongoing mitigation measures (and possible future events), spatial mobility patterns should be a key factor in exploring regional mobility restrictions as an alternative for national lockdowns.

The Efficacy of the Combination of Naproxen and Fexofenadine (SJP-003) to Prevent or Reduce Side Effects of Receiving Multiple Travel Vaccines: A Case Report

A considerable number of travelers receive multiple travel vaccinations before going on holiday. Here, we present a case report of a 56-year-old male traveler. On day 1, he received vaccinations against influenza, Tdab (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis), MMR (measles, mumps, and rubella), yellow fever, and cholera. On days 1,3, 5, and 7, he self-administered an oral vaccine against typhoid. Treatment comprised the combination of 220 mg naproxen and 180 mg fexofenadine (SJP-003), to be taken 4h before and 6h after the vaccinations on day 1, and every 12 h thereafter until the end of day 7. Side effects were noted daily, and their severity was scored on a scale ranging from 0 (absent) to 10 (severe). These reports revealed that, except from a slight bruising at the injection site, no side effects were experienced from day 1 to day 4. After the second dose on day 3, treatment was discontinued. Two hours after taking the typhoid vaccine on Day 5, various flu-like symptoms were reported of moderate to high severity, including fever, muscle aches (both with severity score of 8), headache (severity score 7), and nausea (severity score 6). Therefore, at 2 h after typhoid vaccination on day 5, naproxen and fexofenadine were self-administered. At 4 h thereafter, all symptoms were resolved. Treatment was continued at the 12 h schedule. On day 6 and 7, no side effects were reported. Taken together, this case study suggests that the combination of naproxen and fexofenadine was effective in preventing or reducing vaccination side effects. Therefore, more research is warranted to further evaluate the efficacy of SJP-003.

Rethinking Lockdown Policies in the Pre-Vaccine Era of COVID-19: A Configurational Perspective

The significance of lockdown policies for controlling the COVID-19 pandemic is widely recognized. However, most studies have focused on individual lockdown measures. The effectiveness of lockdown policy combinations has not been examined from a configurational perspective. This research applies fuzzy-set qualitative comparative analysis (fsQCA) to examine different lockdown policy combinations associated with high-epidemic situations in 84 countries. A high-epidemic situation can occur through three different “weak-confined” patterns of lockdown policy combinations. The findings demonstrate that a combination of lockdown policies is more successful than any single lockdown policy, whereas the absence of several key measures in policy combinations can lead to a high-epidemic situation. The importance of international travel controls can become obscured when they are the only measures adopted, and a high-epidemic situation can still arise where restrictions are placed on international travel but not on public transport or when workplaces are closed but schools remain open.

Classification Schemes of COVID-19 High Risk Areas and Resulting Policies: A Rapid Review

The COVID-19 pandemic has posed a significant global health threat since January 2020. Policies to reduce human mobility have been recognized to effectively control the spread of COVID-19; although the relationship between mobility, policy implementation, and virus spread remains contentious, with no clear pattern for how countries classify each other, and determine the destinations to- and from which to restrict travel. In this rapid review, we identified country classification schemes for high-risk COVID-19 areas and associated policies which mirrored the dynamic situation in 2020, with the aim of identifying any patterns that could indicate the effectiveness of such policies. We searched academic databases, including PubMed, Scopus, medRxiv, Google Scholar, and EMBASE. We also consulted web pages of the relevant government institutions in all countries. This rapid review's searches were conducted between October 2020 and December 2021. Web scraping of policy documents yielded additional 43 country reports on high-risk area classification schemes. In 43 countries from which relevant reports were identified, six issued domestic classification schemes. International classification schemes were issued by the remaining 38 countries, and these mainly used case incidence per 100,000 inhabitants as key indicator. The case incidence cut-off also varied across the countries, ranging from 20 cases per 100,000 inhabitants in the past 7 days to more than 100 cases per 100,000 inhabitants in the past 28 days. The criteria used for defining high-risk areas varied across countries, including case count, positivity rate, composite risk scores, community transmission and satisfactory laboratory testing. Countries either used case incidence in the past 7, 14 or 28 days. The resulting policies included restrictions on internal movement and international travel. The quarantine policies can be summarized into three categories: (1) 14 days self-isolation, (2) 10 days self-isolation and (3) 14 days compulsory isolation.

Did border closures slow SARS-CoV-2?

Despite the economic, social, and humanitarian costs of border closures, more than 1000 new international border closures were introduced in response to the 2020-2021 pandemic by nearly every country in the world. The objective of this study was to examine whether these border closures reduced the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Prior to 2020, the impacts of border closures on disease spread were largely unknown, and their use as a pandemic policy was advised against by international organizations. We tested whether they were helpful in reducing spread by using matching techniques on our hand-coded COVID Border Accountability Project (COBAP) Team database of international closures, converted to a time-series cross-sectional data format. We controlled for national-level internal movement restrictions (domestic lockdowns) using the Oxford COVID-19 Government Response Tracker (OxCGRT) time-series data. We found no evidence in favor of international border closures, whereas we found a strong association between national-level lockdowns and a reduced spread of SARS-CoV-2 cases. More research must be done to evaluate the byproduct effects of closures versus lockdowns as well as the efficacy of other preventative measures introduced at international borders.

The Effects of Non-Pharmaceutical Interventions on COVID-19 Epidemic Growth Rate during Pre- and Post-Vaccination Period in Asian Countries

There is little knowledge about how the influence of non-pharmaceutical interventions (NPIs) reduces the COVID-19 infection rate during the period of vaccine rollout. This study aimed to examine the effectiveness of NPIs on decreasing the epidemic growth of COVID-19 between before and after the vaccine rollout period among Asian countries. Our ecological study included observations from 30 Asian countries over the 20 weeks of the pre- and post-vaccination period. Data were extracted from the Oxford COVID-19 Government Response Tracker and other open databases. Longitudinal analysis was utilized to evaluate the impacts of public health responses and vaccines. The facial covering policy was the most effective intervention in the pre-vaccination period, followed by border control and testing policies. In the post-vaccination period, restrictions on gatherings and public transport closure both play a key role in reducing the epidemic growth rate. Vaccine coverage of 1-5%, 5-10%, 10-30%, and over 30% of the population was linked with an average reduction of 0.12%, 0.32%, 0.31%, and 0.59%, respectively. Our findings support the evidence that besides the vaccine increasingly contributing to pandemic control, the implementation of NPIs also plays a key role.

Effects of COVID-19 on Variations of Taxpayers in Tourism-Reliant Regions: The Case of the Mexican Caribbean

Given the tourism industry’s risk and vulnerability to pandemics and the need to better understand the impacts on tourism destinations, this research assesses the effect of the COVID-19 outbreak on the variation of taxpayer units in the Mexican Caribbean region, which includes some of the major sun-and-sand beach destinations in Latin America. Using monthly data of registered taxpayer entities at the state and national levels as the analysis variable, probability distributions and definite integrals are employed to determine variations of the year following the lockdown, compared with previous years’ data. Results indicate that despite the government’s measures to restrict businesses’ operations and a reduction in tourism activities, registered taxpayers at the regional level did not decrease for most of 2020. Further, as business activities and tourism recovered, taxpayer units increased at the end of 2020 and beginning of 2021. Surprisingly, such a pattern was not observed at the national level, which yielded no statistically significant variations. A discussion of factors influencing the resilience of the tourism region in the study (e.g., outbound markets’ geographic proximity, absence of travel restrictions, closure of competing destinations) and implications for public finances are presented.

Acute effect of the COVID-19 pandemic on emergency transportation due to acute alcoholic intoxication: a retrospective observational study

Background

The COVID-19 pandemic has caused changes in people’s drinking habits and the emergency management system for various diseases. However, no studies have investigated the pandemic’s impact on emergency transportation for acute alcoholic intoxication. This study examines the effect of the pandemic on emergency transportation due to acute alcoholic intoxication in Kochi Prefecture, Japan, a region with high alcohol consumption.

Methods

A retrospective observational study was conducted using data of 180,747 patients from the Kochi-Iryo-Net database, Kochi Prefecture’s emergency medical and wide-area disaster information system. Chi-squared tests and multiple logistic regression analyses were performed. The association between emergency transportation and alcoholic intoxication was examined. The differences between the number of transportations during the voluntary isolation period in Japan (March and April 2020) and the same period for 2016–2019 were measured.

Results

In 2020, emergency transportations due to acute alcoholic intoxication declined by 0.2%, compared with previous years. Emergency transportation due to acute alcoholic intoxication decreased significantly between March and April 2020, compared with the same period in 2016–2019, even after adjusting for confounding factors (adjusted odds ratio 0.67; 95% confidence interval 0.47–0.96).

Conclusions

This study showed that lifestyle changes due to the COVID-19 pandemic affected the number of emergency transportations; in particular, those due to acute alcoholic intoxication decreased significantly.