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Zhang X, Yang L, Chen T, Wang Q, Yang J, Zhang T, Yang J, Zhao H, Lai S, Feng L, Yang W. Predicting influenza-like illness trends based on sentinel surveillance data in China from 2011 to 2019: A modelling and comparative study 1. Infect Dis Model 2024; 9:816-827. [PMID: 38725432 PMCID: PMC11079460 DOI: 10.1016/j.idm.2024.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 04/25/2024] [Accepted: 04/26/2024] [Indexed: 05/12/2024] Open
Abstract
Background Influenza is an acute respiratory infectious disease with a significant global disease burden. Additionally, the coronavirus disease 2019 pandemic and its related non-pharmaceutical interventions (NPIs) have introduced uncertainty to the spread of influenza. However, comparative studies on the performance of innovative models and approaches used for influenza prediction are limited. Therefore, this study aimed to predict the trend of influenza-like illness (ILI) in settings with diverse climate characteristics in China based on sentinel surveillance data using three approaches and evaluate and compare their predictive performance. Methods The generalized additive model (GAM), deep learning hybrid model based on Gate Recurrent Unit (GRU), and autoregressive moving average-generalized autoregressive conditional heteroscedasticity (ARMA-GARCH) model were established to predict the trends of ILI 1-, 2-, 3-, and 4-week-ahead in Beijing, Tianjin, Shanxi, Hubei, Chongqing, Guangdong, Hainan, and the Hong Kong Special Administrative Region in China, based on sentinel surveillance data from 2011 to 2019. Three relevant metrics, namely, Mean Absolute Percentage Error (MAPE), Root Mean Squared Error (RMSE), and R squared, were calculated to evaluate and compare the goodness of fit and robustness of the three models. Results Considering the MAPE, RMSE, and R squared values, the ARMA-GARCH model performed best, while the GRU-based deep learning hybrid model exhibited moderate performance and GAM made predictions with the least accuracy in the eight settings in China. Additionally, the models' predictive performance declined as the weeks ahead increased. Furthermore, blocked cross-validation indicated that all models were robust to changes in data and had low risks of overfitting. Conclusions Our study suggested that the ARMA-GARCH model exhibited the best accuracy in predicting ILI trends in China compared to the GAM and GRU-based deep learning hybrid model. Therefore, in the future, the ARMA-GARCH model may be used to predict ILI trends in public health practice across diverse climatic zones, thereby contributing to influenza control and prevention efforts.
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Affiliation(s)
- Xingxing Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100073, China
- State Key Laboratory of Respiratory Health and Multimorbidity, China
- Key Laboratory of Pathogen Infection Prevention and Control (Peking Union Medical College), Ministry of Education, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, China
| | - Liuyang Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100073, China
- State Key Laboratory of Respiratory Health and Multimorbidity, China
- Key Laboratory of Pathogen Infection Prevention and Control (Peking Union Medical College), Ministry of Education, China
- Department of Management Science and Information System, Faculty of Management and Economics, Kunming University of Science and Technology, Kunming, 650506, China
| | - Teng Chen
- Department of Applied Mathematics & Statistics, Stony Brook University, Stony Brook, NY, 11794-3600, USA
| | - Qing Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100073, China
- State Key Laboratory of Respiratory Health and Multimorbidity, China
- Key Laboratory of Pathogen Infection Prevention and Control (Peking Union Medical College), Ministry of Education, China
| | - Jin Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100073, China
- State Key Laboratory of Respiratory Health and Multimorbidity, China
- Key Laboratory of Pathogen Infection Prevention and Control (Peking Union Medical College), Ministry of Education, China
| | - Ting Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100073, China
- State Key Laboratory of Respiratory Health and Multimorbidity, China
- Key Laboratory of Pathogen Infection Prevention and Control (Peking Union Medical College), Ministry of Education, China
| | - Jiao Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100073, China
- State Key Laboratory of Respiratory Health and Multimorbidity, China
- Key Laboratory of Pathogen Infection Prevention and Control (Peking Union Medical College), Ministry of Education, China
| | - Hongqing Zhao
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, China
| | - Shengjie Lai
- WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, SO17 1BJ, UK
| | - Luzhao Feng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100073, China
- State Key Laboratory of Respiratory Health and Multimorbidity, China
- Key Laboratory of Pathogen Infection Prevention and Control (Peking Union Medical College), Ministry of Education, China
| | - Weizhong Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100073, China
- State Key Laboratory of Respiratory Health and Multimorbidity, China
- Key Laboratory of Pathogen Infection Prevention and Control (Peking Union Medical College), Ministry of Education, China
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Qiu W, Ding J, Zhang H, Huang S, Huang Z, Lin M, Zhang Y, Chen Z. Mycoplasma pneumoniae detections in children with lower respiratory infection before and during the COVID-19 pandemic: a large sample study in China from 2019 to 2022. BMC Infect Dis 2024; 24:549. [PMID: 38824572 PMCID: PMC11143586 DOI: 10.1186/s12879-024-09438-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 05/27/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND Nonpharmaceutical interventions (NPIs) implemented to reduce the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have suppressed the spread of other respiratory viruses during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to explore the epidemiological trends and clinical characteristics of Mycoplasma pneumoniae (MP) infection among inpatient children with lower respiratory tract infection (LRTI) before and during the COVID-19 pandemic, and investigate the long-term effects of China's NPIs against COVID-19 on the epidemiology of MP among inpatient children with LRTI. METHODS Children hospitalised for LRTI at the Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine (Hangzhou, China) between January 2019 and December 2022 were tested for common respiratory pathogens, including Mycoplasma pneumoniae (MP), Chlamydia trachomatis (CT) and other bacteria. Clinical data on age, sex, season of onset, disease spectrum, and combined infection in children with MP-induced LRTI in the past 4 years were collected and analysed. RESULTS Overall, 15909 patients were enrolled, and MP-positive cases were 1971 (34.0%), 73 (2.4%), 176 (5.8%), and 952 (20.6%) in 2019, 2020, 2021, and 2022, respectively, with a significant statistical difference in the MP-positive rate over the 4 years (p <0.001). The median age of these children was preschool age (3-6 years), except for 2022, when they were school age (7-12 years), with statistical differences. Comparing the positive rates of different age groups, the school-age children (7-12 years) had the highest positive rate, followed by the preschoolers (3-6 years) in each of the 4 years. Compared among different seasons, the positive rate of MP in children with LRTI was higher in summer and autumn, whereas in 2020, it was highest in spring. The monthly positive rate peaked in July 2019, remained low from 2020 to 2021, and rebounded until 2022. Regarding the disease spectrum, severe pneumonia accounted for the highest proportion (46.3%) pre-pandemic and lowest (0%) in 2020. CONCLUSION Trends in MP detection in children with LRTIs suggest a possible correlation between COVID-19 NPIs and significantly reduced detection rates. The positivity rate of MP gradually rose after 2 years. The epidemic season showed some differences, but school-age children were more susceptible to MP before and during the COVID-19 pandemic.
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Affiliation(s)
- Weiling Qiu
- Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, No.3333 Binsheng Road, Zhejiang, Hangzhou, People's Republic of China
| | - Jiaying Ding
- Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, No.3333 Binsheng Road, Zhejiang, Hangzhou, People's Republic of China
| | - Hongmei Zhang
- Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, No.3333 Binsheng Road, Zhejiang, Hangzhou, People's Republic of China
| | - Shumin Huang
- Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, No.3333 Binsheng Road, Zhejiang, Hangzhou, People's Republic of China
| | - Zuowei Huang
- Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, No.3333 Binsheng Road, Zhejiang, Hangzhou, People's Republic of China
| | - Ming Lin
- Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, No.3333 Binsheng Road, Zhejiang, Hangzhou, People's Republic of China
| | - Yuanyuan Zhang
- Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, No.3333 Binsheng Road, Zhejiang, Hangzhou, People's Republic of China.
| | - Zhimin Chen
- Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, No.3333 Binsheng Road, Zhejiang, Hangzhou, People's Republic of China.
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Alzaydi M, Alosaimi A, Alghamdi AA, Bamogaddam IY, Altassan MA, Almazrua A, Althawadi S, Alghamdi SM. Changes in seasonal respiratory viral infections among pediatric population around the COVID-19 pandemic; 2019-2023. Eur J Clin Microbiol Infect Dis 2024:10.1007/s10096-024-04860-5. [PMID: 38814498 DOI: 10.1007/s10096-024-04860-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 05/23/2024] [Indexed: 05/31/2024]
Abstract
PURPOSE This study aims to describe the prevalence and the fluctuations of respiratory viral infections among the pediatric population in a tertiary care center during 2019-2023, parallel with the COVID-19 pandemic, and the specific preventative measures applied in the region during this time. METHODS In this observational study, we extracted all respiratory virus PCR tests collected from pediatric patients (< 15 years old) between January 2019 and March 2023. Data on the positivity rate and prevalence of 18 respiratory viruses were presented over the study period. RESULTS The lowest rate for the studied respiratory viruses was observed in 2020/2021 (during the COVID-19 pandemic), followed by a gradual increase in positive cases in the 2021/2022 season. Timing (seasonality) was altered during 2022/2023 with an early circulation of respiratory viruses in May-June followed by an early start of the usual respiratory viruses' season in September, leading to prolonged respiratory virus activity. Most respiratory viruses were circulating at unprecedented levels during the 2022/2023 season, with rhinovirus/enterovirus being the most commonly detected virus in all seasons. Other viruses that had atypical activity after the COVID-19 pandemic were influenza A(H3) virus, adenovirus, and parainfluenza 3 virus. CONCLUSION Our study demonstrates the extended influence of the COVID-19 pandemic and its associated community restriction measures on the timing and distribution of other respiratory viruses. Continuous monitoring of changes in the circulation of respiratory viruses is crucial for the success of related public health measures such as vaccination distributions and epidemic preparedness.
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Affiliation(s)
- Mashael Alzaydi
- Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Aeshah Alosaimi
- Infection Control and Hospital Epidemiology Department, King Faisal Specialist Hospital and Research Centre, P.O. Box 3354, Riyadh, 11211, Kingdom of Saudi Arabia.
| | - Atheer A Alghamdi
- Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Israa Y Bamogaddam
- Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Maryam A Altassan
- Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Afnan Almazrua
- Infection Control and Hospital Epidemiology Department, King Faisal Specialist Hospital and Research Centre, P.O. Box 3354, Riyadh, 11211, Kingdom of Saudi Arabia
| | - Sahar Althawadi
- Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Salem M Alghamdi
- Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
- Infection Control and Hospital Epidemiology Department, King Faisal Specialist Hospital and Research Centre, P.O. Box 3354, Riyadh, 11211, Kingdom of Saudi Arabia
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Perofsky AC, Huddleston J, Hansen C, Barnes JR, Rowe T, Xu X, Kondor R, Wentworth DE, Lewis N, Whittaker L, Ermetal B, Harvey R, Galiano M, Daniels RS, McCauley JW, Fujisaki S, Nakamura K, Kishida N, Watanabe S, Hasegawa H, Sullivan SG, Barr IG, Subbarao K, Krammer F, Bedford T, Viboud C. Antigenic drift and subtype interference shape A(H3N2) epidemic dynamics in the United States. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2023.10.02.23296453. [PMID: 37873362 PMCID: PMC10593063 DOI: 10.1101/2023.10.02.23296453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Influenza viruses continually evolve new antigenic variants, through mutations in epitopes of their major surface proteins, hemagglutinin (HA) and neuraminidase (NA). Antigenic drift potentiates the reinfection of previously infected individuals, but the contribution of this process to variability in annual epidemics is not well understood. Here we link influenza A(H3N2) virus evolution to regional epidemic dynamics in the United States during 1997-2019. We integrate phenotypic measures of HA antigenic drift and sequence-based measures of HA and NA fitness to infer antigenic and genetic distances between viruses circulating in successive seasons. We estimate the magnitude, severity, timing, transmission rate, age-specific patterns, and subtype dominance of each regional outbreak and find that genetic distance based on broad sets of epitope sites is the strongest evolutionary predictor of A(H3N2) virus epidemiology. Increased HA and NA epitope distance between seasons correlates with larger, more intense epidemics, higher transmission, greater A(H3N2) subtype dominance, and a greater proportion of cases in adults relative to children, consistent with increased population susceptibility. Based on random forest models, A(H1N1) incidence impacts A(H3N2) epidemics to a greater extent than viral evolution, suggesting that subtype interference is a major driver of influenza A virus infection dynamics, presumably via heterosubtypic cross-immunity.
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Affiliation(s)
- Amanda C Perofsky
- Fogarty International Center, National Institutes of Health, United States
- Brotman Baty Institute for Precision Medicine, University of Washington, United States
| | - John Huddleston
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, United States
| | - Chelsea Hansen
- Fogarty International Center, National Institutes of Health, United States
- Brotman Baty Institute for Precision Medicine, University of Washington, United States
| | - John R Barnes
- Virology Surveillance and Diagnosis Branch, Influenza Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC), United States
| | - Thomas Rowe
- Virology Surveillance and Diagnosis Branch, Influenza Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC), United States
| | - Xiyan Xu
- Virology Surveillance and Diagnosis Branch, Influenza Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC), United States
| | - Rebecca Kondor
- Virology Surveillance and Diagnosis Branch, Influenza Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC), United States
| | - David E Wentworth
- Virology Surveillance and Diagnosis Branch, Influenza Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC), United States
| | - Nicola Lewis
- WHO Collaborating Centre for Reference and Research on Influenza, Crick Worldwide Influenza Centre, The Francis Crick Institute, United Kingdom
| | - Lynne Whittaker
- WHO Collaborating Centre for Reference and Research on Influenza, Crick Worldwide Influenza Centre, The Francis Crick Institute, United Kingdom
| | - Burcu Ermetal
- WHO Collaborating Centre for Reference and Research on Influenza, Crick Worldwide Influenza Centre, The Francis Crick Institute, United Kingdom
| | - Ruth Harvey
- WHO Collaborating Centre for Reference and Research on Influenza, Crick Worldwide Influenza Centre, The Francis Crick Institute, United Kingdom
| | - Monica Galiano
- WHO Collaborating Centre for Reference and Research on Influenza, Crick Worldwide Influenza Centre, The Francis Crick Institute, United Kingdom
| | - Rodney Stuart Daniels
- WHO Collaborating Centre for Reference and Research on Influenza, Crick Worldwide Influenza Centre, The Francis Crick Institute, United Kingdom
| | - John W McCauley
- WHO Collaborating Centre for Reference and Research on Influenza, Crick Worldwide Influenza Centre, The Francis Crick Institute, United Kingdom
| | - Seiichiro Fujisaki
- Influenza Virus Research Center, National Institute of Infectious Diseases, Japan
| | - Kazuya Nakamura
- Influenza Virus Research Center, National Institute of Infectious Diseases, Japan
| | - Noriko Kishida
- Influenza Virus Research Center, National Institute of Infectious Diseases, Japan
| | - Shinji Watanabe
- Influenza Virus Research Center, National Institute of Infectious Diseases, Japan
| | - Hideki Hasegawa
- Influenza Virus Research Center, National Institute of Infectious Diseases, Japan
| | - Sheena G Sullivan
- WHO Collaborating Centre for Reference and Research on Influenza, The Peter Doherty Institute for Infection and Immunity, Department of Microbiology and Immunology, The University of Melbourne, The Peter Doherty Institute for Infection and Immunity, Australia
| | - Ian G Barr
- WHO Collaborating Centre for Reference and Research on Influenza, The Peter Doherty Institute for Infection and Immunity, Department of Microbiology and Immunology, The University of Melbourne, The Peter Doherty Institute for Infection and Immunity, Australia
| | - Kanta Subbarao
- WHO Collaborating Centre for Reference and Research on Influenza, The Peter Doherty Institute for Infection and Immunity, Department of Microbiology and Immunology, The University of Melbourne, The Peter Doherty Institute for Infection and Immunity, Australia
| | - Florian Krammer
- Center for Vaccine Research and Pandemic Preparedness (C-VaRPP), Icahn School of Medicine at Mount Sinai, United States
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, United States
| | - Trevor Bedford
- Brotman Baty Institute for Precision Medicine, University of Washington, United States
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, United States
- Department of Genome Sciences, University of Washington, United States
- Howard Hughes Medical Institute, Seattle, United States
| | - Cécile Viboud
- Fogarty International Center, National Institutes of Health, United States
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5
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Xu RH, Sun R, Fu SN. Out-of-Hospital Cardiac Arrest Before and During the COVID-19 Pandemic in Hong Kong: Registry-Based Study From 2017 to 2023. JMIR Public Health Surveill 2024; 10:e56054. [PMID: 38771620 DOI: 10.2196/56054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 03/03/2024] [Accepted: 04/19/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has exerted a significant toll on individual health and the efficacy of health care systems. However, the influence of COVID-19 on the frequency and outcomes of out-of-hospital cardiac arrest (OHCA) within the Chinese population, both before and throughout the entire pandemic period, remains to be clarified. OBJECTIVE This study aimed to fill the gaps by investigating the prevalence and outcomes of OHCA in Hong Kong (HK) both before and during the whole pandemic period. METHODS This is a retrospective regional registry study. The researchers matched OHCA data with COVID-19-confirmed case records between December 2017 and May 2023. The data included information on response times, location of OHCA, witness presence, initial rhythm, bystander cardiopulmonary resuscitation (CPR), use of public-access defibrillation, resuscitation in the accident and emergency department, and survival to admission. Descriptive analyses were conducted, and statistical tests such as analysis of variance and χ2 were used to examine differences between variables. The incidence of OHCA and survival rates were calculated, and logistic regression analysis was performed to assess associations. The prevalence of OHCA and COVID-19 during the peak of the pandemic was also described. RESULTS A total of 43,882 cases of OHCA were reported in HK and included in our analysis. Around 13,946 cases were recorded during the prepandemic period (2017-2019), and the remaining 29,936 cases were reported during the pandemic period (2020-2023). During the pandemic period, the proportion of female patients increased to 44.1% (13,215/29,936), and the average age increased slightly to 76.5 (SD 18.5) years. The majority of OHCAs (n=18,143, 61.1% cases) occurred at home. A witness was present in 45.9% (n=10,723) of the cases, and bystander CPR was initiated in 44.6% (n=13,318) of the cases. There was a significant increase in OHCA incidence, with a corresponding decrease in survival rates compared to the prepandemic period. The location of OHCA shifted, with a decrease in incidents in public places and a potential increase in incidents at home. We found that CPR (odds ratio 1.48, 95% CI 1.17-1.86) and public-access defibrillation (odds ratio 1.16, 95% CI 1.05-1.28) were significantly associated with a high survival to admission rate during the pandemic period. There was a correlation between the development of OHCA and the prevalence of COVID-19 in HK. CONCLUSIONS The COVID-19 pandemic has had a significant impact on OHCA in HK, resulting in increased incidence and decreased survival rates. The findings highlight the importance of addressing the indirect effects of the pandemic, such as increased stress levels and strain on health care systems, on OHCA outcomes. Strategies should be developed to improve OHCA prevention, emergency response systems, and health care services during public health emergencies to mitigate the impact on population health.
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Affiliation(s)
- Richard Huan Xu
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Kowloon, China (Hong Kong)
| | - Ruiqi Sun
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Kowloon, China (Hong Kong)
| | - Siu-Ngor Fu
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Kowloon, China (Hong Kong)
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Perofsky AC, Hansen CL, Burstein R, Boyle S, Prentice R, Marshall C, Reinhart D, Capodanno B, Truong M, Schwabe-Fry K, Kuchta K, Pfau B, Acker Z, Lee J, Sibley TR, McDermot E, Rodriguez-Salas L, Stone J, Gamboa L, Han PD, Adler A, Waghmare A, Jackson ML, Famulare M, Shendure J, Bedford T, Chu HY, Englund JA, Starita LM, Viboud C. Impacts of human mobility on the citywide transmission dynamics of 18 respiratory viruses in pre- and post-COVID-19 pandemic years. Nat Commun 2024; 15:4164. [PMID: 38755171 PMCID: PMC11098821 DOI: 10.1038/s41467-024-48528-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 05/02/2024] [Indexed: 05/18/2024] Open
Abstract
Many studies have used mobile device location data to model SARS-CoV-2 dynamics, yet relationships between mobility behavior and endemic respiratory pathogens are less understood. We studied the effects of population mobility on the transmission of 17 endemic viruses and SARS-CoV-2 in Seattle over a 4-year period, 2018-2022. Before 2020, visits to schools and daycares, within-city mixing, and visitor inflow preceded or coincided with seasonal outbreaks of endemic viruses. Pathogen circulation dropped substantially after the initiation of COVID-19 stay-at-home orders in March 2020. During this period, mobility was a positive, leading indicator of transmission of all endemic viruses and lagging and negatively correlated with SARS-CoV-2 activity. Mobility was briefly predictive of SARS-CoV-2 transmission when restrictions relaxed but associations weakened in subsequent waves. The rebound of endemic viruses was heterogeneously timed but exhibited stronger, longer-lasting relationships with mobility than SARS-CoV-2. Overall, mobility is most predictive of respiratory virus transmission during periods of dramatic behavioral change and at the beginning of epidemic waves.
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Affiliation(s)
- Amanda C Perofsky
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA, USA.
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA.
| | - Chelsea L Hansen
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA, USA
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
- PandemiX Center, Department of Science & Environment, Roskilde University, Roskilde, Denmark
| | - Roy Burstein
- Institute for Disease Modeling, Bill & Melinda Gates Foundation, Seattle, WA, USA
| | - Shanda Boyle
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA, USA
| | - Robin Prentice
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA, USA
| | - Cooper Marshall
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA, USA
| | - David Reinhart
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA, USA
| | - Ben Capodanno
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA, USA
| | - Melissa Truong
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA, USA
| | - Kristen Schwabe-Fry
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA, USA
| | - Kayla Kuchta
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA, USA
| | - Brian Pfau
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA, USA
| | - Zack Acker
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA, USA
| | - Jover Lee
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Thomas R Sibley
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Evan McDermot
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA, USA
| | - Leslie Rodriguez-Salas
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA, USA
| | - Jeremy Stone
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA, USA
| | - Luis Gamboa
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA, USA
| | - Peter D Han
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA, USA
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Amanda Adler
- Seattle Children's Research Institute, Seattle, WA, USA
| | - Alpana Waghmare
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
- Seattle Children's Research Institute, Seattle, WA, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | | | - Michael Famulare
- Institute for Disease Modeling, Bill & Melinda Gates Foundation, Seattle, WA, USA
| | - Jay Shendure
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA, USA
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
- Howard Hughes Medical Institute, Seattle, WA, USA
| | - Trevor Bedford
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA, USA
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
- Howard Hughes Medical Institute, Seattle, WA, USA
| | - Helen Y Chu
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Janet A Englund
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA, USA
- Seattle Children's Research Institute, Seattle, WA, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Lea M Starita
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA, USA
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Cécile Viboud
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
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Arcaro P, Nachira L, Pattavina F, Campo E, Mancini R, Pascucci D, Damiani G, Carducci B, Spadea A, Lanzone A, Bruno S, Laurenti P. Assessing the Impact of the COVID-19 Pandemic on Pregnant Women's Attitudes towards Childhood Vaccinations: A Cross-Sectional Study. Vaccines (Basel) 2024; 12:473. [PMID: 38793724 PMCID: PMC11126003 DOI: 10.3390/vaccines12050473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/15/2024] [Accepted: 04/24/2024] [Indexed: 05/26/2024] Open
Abstract
The COVID-19 pandemic has globally disrupted immunisation practices, impacting vulnerable populations such as pregnant women (PW), who harbour concerns about future children's immunisations. This study aimed to assess the pandemic's impact on PW's attitudes towards childhood vaccinations. During three consecutive flu seasons from October 2019 to January 2022, a cross-sectional study was conducted in a large Italian teaching hospital using a questionnaire. The chi-square test was performed to compare each season. Across the 2019-2020 to 2021-2022 seasons, course attendance by PW surged from 105 to 340. Significant shifts in vaccination intentions were noted, including a 7.5% decrease in measles vaccination intent (p = 0.02) and a 10% decrease in that of pertussis (p = 0.004) from 2019-2020 to 2020-2021. While perceived contagion risk decreased, disease severity perceptions increased, with few significant differences. A statistically significant reduction was noted in the proportion of participants suspecting economic motives behind NHS workers' promotion of childhood vaccinations. Furthermore, the pandemic period saw an increase in the perceived utility of non-institutional websites and the advice of physicians outside the NHS. These findings will help develop evidence-based, tailored interventions and communication strategies to address vaccine hesitancy and ensure optimal vaccination coverage among children born during and after the pandemic.
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Affiliation(s)
- Paola Arcaro
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (P.A.); (L.N.); (E.C.); (R.M.); (G.D.); (S.B.); (P.L.)
| | - Lorenza Nachira
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (P.A.); (L.N.); (E.C.); (R.M.); (G.D.); (S.B.); (P.L.)
| | - Fabio Pattavina
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (B.C.); (A.L.)
| | - Enrica Campo
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (P.A.); (L.N.); (E.C.); (R.M.); (G.D.); (S.B.); (P.L.)
| | - Rossella Mancini
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (P.A.); (L.N.); (E.C.); (R.M.); (G.D.); (S.B.); (P.L.)
| | - Domenico Pascucci
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (P.A.); (L.N.); (E.C.); (R.M.); (G.D.); (S.B.); (P.L.)
- Health Management, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Gianfranco Damiani
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (P.A.); (L.N.); (E.C.); (R.M.); (G.D.); (S.B.); (P.L.)
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (B.C.); (A.L.)
| | - Brigida Carducci
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (B.C.); (A.L.)
| | | | - Antonio Lanzone
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (B.C.); (A.L.)
| | - Stefania Bruno
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (P.A.); (L.N.); (E.C.); (R.M.); (G.D.); (S.B.); (P.L.)
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (B.C.); (A.L.)
| | - Patrizia Laurenti
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (P.A.); (L.N.); (E.C.); (R.M.); (G.D.); (S.B.); (P.L.)
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (B.C.); (A.L.)
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Liao Q, Yuan J, Wong IOL, Ni MY, Cowling BJ, Lam WWT. Motivators and Demotivators for COVID-19 Vaccination Based on Co-Occurrence Networks of Verbal Reasons for Vaccination Acceptance and Resistance: Repetitive Cross-Sectional Surveys and Network Analysis. JMIR Public Health Surveill 2024; 10:e50958. [PMID: 38648099 DOI: 10.2196/50958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/21/2023] [Accepted: 02/27/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Vaccine hesitancy is complex and multifaced. People may accept or reject a vaccine due to multiple and interconnected reasons, with some reasons being more salient in influencing vaccine acceptance or resistance and hence the most important intervention targets for addressing vaccine hesitancy. OBJECTIVE This study was aimed at assessing the connections and relative importance of motivators and demotivators for COVID-19 vaccination in Hong Kong based on co-occurrence networks of verbal reasons for vaccination acceptance and resistance from repetitive cross-sectional surveys. METHODS We conducted a series of random digit dialing telephone surveys to examine COVID-19 vaccine hesitancy among general Hong Kong adults between March 2021 and July 2022. A total of 5559 and 982 participants provided verbal reasons for accepting and resisting (rejecting or hesitating) a COVID-19 vaccine, respectively. The verbal reasons were initially coded to generate categories of motivators and demotivators for COVID-19 vaccination using a bottom-up approach. Then, all the generated codes were mapped onto the 5C model of vaccine hesitancy. On the basis of the identified reasons, we conducted a co-occurrence network analysis to understand how motivating or demotivating reasons were comentioned to shape people's vaccination decisions. Each reason's eigenvector centrality was calculated to quantify their relative importance in the network. Analyses were also stratified by age group. RESULTS The co-occurrence network analysis found that the perception of personal risk to the disease (egicentrality=0.80) and the social responsibility to protect others (egicentrality=0.58) were the most important comentioned reasons that motivate COVID-19 vaccination, while lack of vaccine confidence (egicentrality=0.89) and complacency (perceived low disease risk and low importance of vaccination; egicentrality=0.45) were the most important comentioned reasons that demotivate COVID-19 vaccination. For older people aged ≥65 years, protecting others was a more important motivator (egicentrality=0.57), while the concern about poor health status was a more important demotivator (egicentrality=0.42); for young people aged 18 to 24 years, recovering life normalcy (egicentrality=0.20) and vaccine mandates (egicentrality=0.26) were the more important motivators, while complacency (egicentrality=0.77) was a more important demotivator for COVID-19 vaccination uptake. CONCLUSIONS When disease risk is perceived to be high, promoting social responsibility to protect others is more important for boosting vaccination acceptance. However, when disease risk is perceived to be low and complacency exists, fostering confidence in vaccines to address vaccine hesitancy becomes more important. Interventions for promoting vaccination acceptance and reducing vaccine hesitancy should be tailored by age.
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Affiliation(s)
- Qiuyan Liao
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Jiehu Yuan
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Irene Oi Ling Wong
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
- World Health Organization Collaborating Center for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Michael Yuxuan Ni
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
- State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong, China (Hong Kong)
- Urban Systems Institute, University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Benjamin John Cowling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
- World Health Organization Collaborating Center for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
- Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, Hong Kong, China (Hong Kong)
| | - Wendy Wing Tak Lam
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
- Jockey Club Institute of Cancer Care, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China (Hong Kong)
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Tsang TK, Du RQR, Fang VJ, Lau EHY, Chan KH, Chu DKW, Ip DKM, Peiris JSM, Leung GM, Cauchemez S, Cowling BJ. Decreased risk of non-influenza respiratory infection after influenza B virus infection in children. Epidemiol Infect 2024; 152:e60. [PMID: 38584132 PMCID: PMC11062782 DOI: 10.1017/s0950268824000542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 01/23/2024] [Accepted: 03/13/2024] [Indexed: 04/09/2024] Open
Abstract
Previous studies suggest that influenza virus infection may provide temporary non-specific immunity and hence lower the risk of non-influenza respiratory virus infection. In a randomized controlled trial of influenza vaccination, 1 330 children were followed-up in 2009-2011. Respiratory swabs were collected when they reported acute respiratory illness and tested against influenza and other respiratory viruses. We used Poisson regression to compare the incidence of non-influenza respiratory virus infection before and after influenza virus infection. Based on 52 children with influenza B virus infection, the incidence rate ratio (IRR) of non-influenza respiratory virus infection after influenza virus infection was 0.47 (95% confidence interval: 0.27-0.82) compared with before infection. Simulation suggested that this IRR was 0.87 if the temporary protection did not exist. We identified a decreased risk of non-influenza respiratory virus infection after influenza B virus infection in children. Further investigation is needed to determine if this decreased risk could be attributed to temporary non-specific immunity acquired from influenza virus infection.
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Affiliation(s)
- Tim K. Tsang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
- Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, Hong Kong
| | - Richael Q. R. Du
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Vicky J. Fang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Eric H. Y. Lau
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
- Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, Hong Kong
| | - Kwok Hung Chan
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Daniel K. W. Chu
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Dennis K. M. Ip
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - J. S. Malik Peiris
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
- HKU-Pasteur Research Pole, The University of Hong Kong, Hong Kong
- Centre for Immunology and Infection, Hong Kong Science and Technology Park, Hong Kong
| | - Gabriel M. Leung
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
- Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, Hong Kong
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, CNRS, Paris, France
| | - Benjamin J. Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
- Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, Hong Kong
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Boyanton BL, Frenner RA, Ingold A, Ambroggio L, Kennedy JL. SARS-CoV-2 pandemic non-pharmacologic interventions temporally associated with reduced pediatric infections due to Mycoplasma pneumoniae and co-infecting respiratory viruses in Arkansas. Microbiol Spectr 2024; 12:e0290823. [PMID: 38488365 PMCID: PMC10986484 DOI: 10.1128/spectrum.02908-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 02/12/2024] [Indexed: 03/26/2024] Open
Abstract
Non-pharmacologic interventions (NPIs), such as universal masking, implemented during the SARS-CoV-2 pandemic have reduced respiratory infections among children. This study evaluated the impact of NPIs on Mycoplasma pneumoniae infections in children, analyzing data from two hospitals in Arkansas and examining age-related differences and co-infections with other respiratory viruses. The study was approved by the Institutional Review Board and included patients (≤18 years) with upper respiratory tract symptoms. Data generated from the FilmArray Respiratory Panel were divided into pre-NPI, NPI, and post-NPI periods for analysis. Overall test positivity rate and positivity rate interval changes were evaluated. Statistical differences were determined by Chi-square (χ2 independence) analysis. A total of 100,077 tests were performed, with a statistical increase in testing volume during the NPI and post-NPI periods. The number of positive M. pneumoniae tests decreased by 77% (77 to 18) during the NPI period, then increased by 50% (18 to 27) during the post-NPI period. Preschool and elementary school age groups had the highest number of positive tests during the study at 59 (48%) and 40 (33%), respectively. Reduced M. pneumoniae infections were consistent across age groups. Co-infections with other respiratory viruses, particularly human rhinovirus/enterovirus, were observed at much lower levels. Pediatric M. pneumoniae infections in Arkansas were temporally associated with implementation and discontinuation of NPIs. Specific viral co-infections still occurred, albeit at lower levels during the SARS-CoV-2 pandemic. Because of the slower growth of this bacterium, we expect M. pneumoniae infections to return to pre-pandemic levels within approximately 2 years. IMPORTANCE Non-pharmacologic interventions (NPIs) effectively curtailed the spread of SARS-CoV-2 and, fortuitously, many other aerosol-transmitted respiratory pathogens. This study included the largest data set of symptomatic, pediatric patients from within the United States spanning a period from November 2017 through December 2023, and encompassed individuals residing in both rural and urban settings. We observed a strong correlation between the implementation and cessation of NPIs with the rate of respiratory infections due to Mycoplasma pneumoniae and viral co-infections. These infections are returning to baseline levels approximately 2 years following NPI cessation. This observation was not unexpected since the replication time for viruses is exponentially faster than that of bacteria. The resurgence of M. pneumoniae and likely other atypical bacterial pathogens is currently in process. Healthcare providers should strongly consider these pathogens in individuals presenting with respiratory tract illnesses.
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Affiliation(s)
- Bobby L. Boyanton
- Department of Pathology, Arkansas Children's Hospital, Little Rock, Arkansas, USA
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Rachel A. Frenner
- Department of Pathology, Arkansas Children's Hospital, Little Rock, Arkansas, USA
| | - Ashton Ingold
- Arkansas Children’s Research Institute, Little Rock, Arkansas, USA
| | - Lilliam Ambroggio
- Sections of Emergency Medicine and Hospital Medicine, Children's Hospital Colorado, Aurora, Colorado, USA
- Department of Pediatrics, University of Colorado, Aurora, Colorado, USA
| | - Joshua L. Kennedy
- Arkansas Children’s Research Institute, Little Rock, Arkansas, USA
- Departments of Pediatrics and Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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Klee B, Diexer S, Horn J, Langer S, Wende M, Ortiz D, Bielecka A, Strowig T, Mikolajczyk R, Gottschick C. The impact of non-pharmaceutical interventions on community non-SARS-CoV-2 respiratory infections in preschool children. BMC Pediatr 2024; 24:231. [PMID: 38561704 PMCID: PMC10985994 DOI: 10.1186/s12887-024-04686-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 03/02/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Effects of non-pharmaceutical interventions during the pandemic were mainly studied for severe outcomes. Among children, most of the burden of respiratory infections is related to infections which are not medically attended. The perspective on infections in the community setting is necessary to understand the effects of the pandemic on non-pharmaceutical interventions. METHODS In the unique prospective LoewenKIDS cohort study, we compared the true monthly incidence of self-reported acute respiratory infections (ARI) in about 350 participants (aged 3-4 years old) between October 2019 to March 2020 (pre-pandemic period) and October 2020 to March 2021 (pandemic period). Parents reported children's symptoms using a diary. Parents were asked to take a nasal swab of their child during all respiratory symptoms. We analysed 718 swabs using Multiplex PCR for 25 common respiratory viruses and bacteria. RESULTS During the pre-pandemic period, on average 44.6% (95% CI: 39.5-49.8%) of children acquired at least one ARI per month compared to 19.9% (95% CI: 11.1-28.7%) during the pandemic period (Incidence Rate Ratio = 0.47; 95% CI: 0.41-0.54). The detection of influenza virus decreased absolute by 96%, respiratory syncytial virus by 65%, metapneumovirus by 95%, parainfluenza virus by 100%, human enterovirus by 96% and human bocavirus by 70% when comparing the pre-pandemic to the pandemic period. However, rhinoviruses were nearly unaffected by NPI. Co-detection (detection of more than one virus in a single symptomatic swab) was common in the pre-pandemic period (222 of 390 samples with viral detection; 56.9%) and substantially less common during the pandemic period (46 of 216 samples; 21.3%). CONCLUSION Non-pharmaceutical interventions strongly reduced the incidence of all respiratory infections in preschool children but did not affect rhinovirus.
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Affiliation(s)
- Bianca Klee
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Sophie Diexer
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Johannes Horn
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Susan Langer
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Marie Wende
- Helmholtz Centre for Infection Research, Braunschweig, Germany
- German Centre for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany
| | - Diego Ortiz
- Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Agata Bielecka
- Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Till Strowig
- Helmholtz Centre for Infection Research, Braunschweig, Germany
- German Centre for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany
- Hannover Medical School, Cluster of Excellence RESIST (EXC 2155), Hannover, Germany
| | - Rafael Mikolajczyk
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
- Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Cornelia Gottschick
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
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Stutz C, Alcantara DMC, dos Santos CM, Torres JM, Rodrigues R, Marcon GEB, Ferreira EDC, Sarti ECFB, de Oliveira TF, Mendes FML, Lemos EF, Demarchi LHF, Lichs GGDC, Zardin MCSU, Gonçalves CCM, Guilhermino JDF, Perdomo RT, Fernandez ZDC. Seroprevalence of antibodies against SARS-CoV-2 in the school community in Campo Grande, state of Mato Grosso do Sul, Brazil, October 2021-November 2022. Front Immunol 2024; 15:1354786. [PMID: 38596680 PMCID: PMC11002276 DOI: 10.3389/fimmu.2024.1354786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 02/29/2024] [Indexed: 04/11/2024] Open
Abstract
Introduction With the reopening of schools during the coronavirus disease 2019 (COVID-19) pandemic, it was imperative to understand the role of students and education professionals in the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this paper, we determined the seroprevalence of the SARS-CoV-2 anti-nucleocapsid antibodies in the school community in Campo Grande, the capital and most populous city of the state of Mato Grosso do Sul (Brazil) and evaluated its association with sex, school level, and school type. Materials and methods The survey was carried out in 20 public and private schools in the urban region of Campo Grande using the TR DPP® COVID-19 immunoglobulin M/immunoglobulin G (IgM/IgG) kit from the Immunobiological Technology Institute (Bio-Manguinhos, Rio de Janeiro, Brazil). Testing was carried out in three periods: from October to December 2021; from March to July 2022; and from August to November 2022. The participants were students aged 6-17 years enrolled in primary or secondary schools and professionals of different ages and roles. Results During the first testing period, 162 participants were seropositive for the IgM and/or IgG anti-nucleocapsid SARS-CoV-2 antibodies, with an estimated seroprevalence of 19.6% using Bayesian multilevel regression. In the second period, 251 participants were seropositive (estimated seroprevalence, 34.6%), while in the third period, 393 participants were seroconverted (estimated seroprevalence, 56.7%). In 2022, there was an increase in the seroconversion rate compared to that in 2021. The most frequently described acute manifestations in the three periods were fever, headache, sore throat, and runny nose. In terms of the demographic profile, there was no predominance of seropositivity between the sexes, although women represented approximately 70% of the study population. There were also no differences between students and school staff. Discussion The results made it possible to evaluate the extent of SARS-CoV-2 transmission in the school community through immunity developed against the virus, in addition to providing information about COVID-19 symptoms in children, adolescents, and adults.
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Affiliation(s)
- Claudia Stutz
- Fiocruz Ceará, Fundação Oswaldo Cruz (Fiocruz), Eusébio, Ceará, Brazil
- Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Ciências Farmacêuticas, Alimentos e Nutrição (FACFAN), Fundação Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, Mato Grosso do Sul, Brazil
| | | | - Camila Maria dos Santos
- Fiocruz Mato Grosso do Sul, Fundação Oswaldo Cruz (Fiocruz), Campo Grande, Mato Grosso do Sul, Brazil
| | - Jaire Marinho Torres
- Fiocruz Mato Grosso do Sul, Fundação Oswaldo Cruz (Fiocruz), Campo Grande, Mato Grosso do Sul, Brazil
| | - Rudielle Rodrigues
- Fiocruz Mato Grosso do Sul, Fundação Oswaldo Cruz (Fiocruz), Campo Grande, Mato Grosso do Sul, Brazil
| | | | - Eduardo de Castro Ferreira
- Fiocruz Mato Grosso do Sul, Fundação Oswaldo Cruz (Fiocruz), Campo Grande, Mato Grosso do Sul, Brazil
- Programa de Pós-graduação em Doenças Infecciosas e Parasitárias, Faculdade de Medicina (FAMED), Fundação Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, Mato Grosso do Sul, Brazil
| | | | | | - Flavia Maria Lins Mendes
- Fiocruz Mato Grosso do Sul, Fundação Oswaldo Cruz (Fiocruz), Campo Grande, Mato Grosso do Sul, Brazil
| | - Everton Ferreira Lemos
- Universidade Estadual de Mato Grosso do Sul (UEMS), Campo Grande, Mato Grosso do Sul, Brazil
| | - Luiz Henrique Ferraz Demarchi
- Laboratório Central de Saúde Pública do Estado de Mato Grosso do Sul (LACEN-MS), Campo Grande, Mato Grosso do Sul, Brazil
| | - Gislene Garcia de Castro Lichs
- Laboratório Central de Saúde Pública do Estado de Mato Grosso do Sul (LACEN-MS), Campo Grande, Mato Grosso do Sul, Brazil
| | | | - Crhistinne Cavalheiro Maymone Gonçalves
- Programa de Pós-graduação em Doenças Infecciosas e Parasitárias, Faculdade de Medicina (FAMED), Fundação Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, Mato Grosso do Sul, Brazil
- Secretaria de Estado de Saúde de Mato Grosso do Sul, Secretaria Adjunta de Estado, Campo Grande, Mato Grosso do Sul, Brazil
| | | | - Renata Trentin Perdomo
- Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Ciências Farmacêuticas, Alimentos e Nutrição (FACFAN), Fundação Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, Mato Grosso do Sul, Brazil
- Laboratório de Biologia Molecular e Cultura Celular da Faculdade de Ciências Farmacêuticas, Alimentos e Nutrição (FACFAN), Fundação Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, Mato Grosso do Sul, Brazil
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13
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Chan W, Cheang C. Seizing pandemic lessons: a call to reinvent public health and healthcare policy planning in post-COVID-19 Hong Kong. Front Public Health 2024; 12:1378148. [PMID: 38560440 PMCID: PMC10978786 DOI: 10.3389/fpubh.2024.1378148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Affiliation(s)
| | - Chonin Cheang
- Faculty of Health Sciences, University of Macau, Macau, Macao SAR, China
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Gan YZ, Yang P, Liu R, Wang YH, Hu YW, Yang Y. Changes in Spectrum of Respiratory Pathogen Infections and Disease Severity Among Children in Hohhot, China: Impact of COVID-19 Prevention Measures. Med Sci Monit 2024; 30:e942845. [PMID: 38451880 DOI: 10.12659/msm.942845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND This retrospective study evaluated the effects of specific COVID-19 preventive measures, including the use of medical masks, nucleic acid testing, and patient isolation, on respiratory infections, disease severity, and seasonal patterns among children in Hohhot, located in northern China. Understanding these alterations is pivotal in developing effective strategies to handle pediatric respiratory infections within the context of continuous public health initiatives. MATERIAL AND METHODS At the First Hospital of Hohhot, throat swabs were collected from 605 children with community-acquired respiratory between January 2022 and March 2023 for pathogen infection spectrum detection using microarray testing. RESULTS Among the patients, 56.03% were male, and their average age was 3.45 years. SARS-CoV-2 infections were highest between October 2022 and January 2023. Influenza A peaked in March 2023, and other pathogens such as respiratory syncytial virus and influenza B virus disappeared after December 2022. The proportion of mixed infections was 41.94% among SARS-CoV-2 patients, while other pathogens had mixed infection rates exceeding 57.14%. Before December 2022, the mean WBC count for Streptococcus pneumoniae and Haemophilus influenzae was 8.83×10⁹/L, CRP was 18.36 mg/L, and PCT was 1.11 ng/ml. After December 2022, these values decreased significantly. Coughing, difficulty breathing, running nose, and lower respiratory tract infection diagnoses decreased in December 2022, except for SARS-CoV-2 infections. CONCLUSIONS SARS-CoV-2 peaked around November 2022, influenza A peaked in March 2023, and other pathogens like respiratory syncytial virus and influenza B virus were greatly reduced after December 2022. Inflammatory markers and respiratory symptoms decreased after December 2022, except for SARS-CoV-2.
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Affiliation(s)
- Yan-Zi Gan
- Child Health Department, The First Hospital of Hohhot, Hohhot, Inner Mongolia, China (mainland)
| | - Peng Yang
- Neurophysiology Department, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China (mainland)
| | - Rui Liu
- The State Key Laboratory of Reproductive Regulation and Breeding of Grassland Livestock, School of Life Sciences, Inner Mongolia University, Hohhot, Inner Mongolia, China (mainland)
| | - Yan-Hai Wang
- Child Health Department, The First Hospital of Hohhot, Hohhot, Inner Mongolia, China (mainland)
| | - Yu-Wei Hu
- Child Health Department, The First Hospital of Hohhot, Hohhot, Inner Mongolia, China (mainland)
| | - Yang Yang
- The State Key Laboratory of Reproductive Regulation and Breeding of Grassland Livestock, School of Life Sciences, Inner Mongolia University, Hohhot, Inner Mongolia, China (mainland)
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15
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Lawrence A. Evaluating the Effectiveness of Public Health Measures During Infectious Disease Outbreaks: A Systematic Review. Cureus 2024; 16:e55893. [PMID: 38595888 PMCID: PMC11003486 DOI: 10.7759/cureus.55893] [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] [Accepted: 03/10/2024] [Indexed: 04/11/2024] Open
Abstract
Over the previous three decades, the incidence of infectious disease outbreaks has considerably increased and the trend is expected to increase further. Public health measures are essential for controlling and preventing emerging outbreaks of infectious illnesses. This study is aimed at evaluating the effectiveness of public health measures during infectious disease outbreaks by summarizing the outcomes from the available evidence in the literature. A systematic review was carried out through a detailed search strategy using specific keywords applied across different electronic databases, including the Science Direct, PubMed, and EMBASE databases. Studies published between 2015 and 2024 were included with a focus on cohorts, clinical trials, longitudinal studies, case-control, and quasi-experimental studies. Low-quality studies and those published before 2015 along with incorrect findings or measures were excluded. A standardized form was used for data extraction. The quality of included studies and the risk of bias were assessed through relevant techniques. The obtained data was narrative synthesized and findings were organized systematically. The reviewed studies revealed that public health measures are considerably effective against infectious disease outbreaks. The success of various measures such as social isolation, confinement measures, and public education on hygiene against different outbreaks of respiratory infectious diseases has been well-established in the literature. Moreover, the timing of intervention application plays a vital role in their success. The implementation in the early phase of an outbreak is highly effective, as it protects more people from infection and controls the overall burden of the disease. The systematic review provided valuable insights into the efficiency of public health measures in monitoring outbreaks of infectious illnesses. The main findings suggest that appropriate public health interventions are effective in controlling the incidence of contagious disease outbreaks. Ongoing research strives to investigate measures that are most effective from the perspective of public health against various transmittable diseases to prevent future outbreaks.
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Affiliation(s)
- Adewale Lawrence
- Pharmaceutical Medicine, Bioluminux Clinical Research, Naperville, USA
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16
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Lai FTT, Liu W, Hu Y, Wei C, Chu RYK, Lum DH, Leung JCN, Cheng FWT, Chui CSL, Li X, Wan EYF, Wong CKH, Cheung CL, Chan EWY, Hung IFN, Wong ICK. Elevated risk of multimorbidity post-COVID-19 infection: protective effect of vaccination. QJM 2024; 117:125-132. [PMID: 37824396 DOI: 10.1093/qjmed/hcad236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 10/05/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND It is unclear how the coronavirus disease 2019 (Covid-19) pandemic has affected multimorbidity incidence among those with one pre-existing chronic condition, as well as how vaccination could modify this association. AIM To examine the association of Covid-19 infection with multimorbidity incidence among people with one pre-existing chronic condition, including those with prior vaccination. DESIGN Nested case-control study. METHODS We conducted a territory-wide nested case-control study with incidence density sampling using Hong Kong electronic health records from public healthcare facilities and mandatory Covid-19 reports. People with one listed chronic condition (based on a list of 30) who developed multimorbidity during 1 January 2020-15 November 2022 were selected as case participants and randomly matched with up to 10 people of the same age, sex and with the same first chronic condition without having developed multimorbidity at that point. Conditional logistic regression was used to estimate adjusted odds ratios (aORs) of multimorbidity. RESULTS In total, 127 744 case participants were matched with 1 230 636 control participants. Adjusted analysis showed that there were 28%-increased odds of multimorbidity following Covid-19 [confidence interval (CI) 22% to 36%] but only 3% (non-significant) with prior full vaccination with BNT162b2 or CoronaVac (95% CI -2% to 7%). Similar associations were observed in men, women, older people aged 65 or more, and people aged 64 or younger. CONCLUSIONS We found a significantly elevated risk of multimorbidity following a Covid-19 episode among people with one pre-existing chronic condition. Full vaccination significantly reduced this risk increase.
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Affiliation(s)
- F T T Lai
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, Centre for Safe Medication Practice and Research, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Sha Tin, Hong Kong SAR, China
| | - W Liu
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, Centre for Safe Medication Practice and Research, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Y Hu
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, Centre for Safe Medication Practice and Research, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - C Wei
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, Centre for Safe Medication Practice and Research, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - R Y K Chu
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, Centre for Safe Medication Practice and Research, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - D H Lum
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, Centre for Safe Medication Practice and Research, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - J C N Leung
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, Centre for Safe Medication Practice and Research, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - F W T Cheng
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, Centre for Safe Medication Practice and Research, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - C S L Chui
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Sha Tin, Hong Kong SAR, China
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - X Li
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, Centre for Safe Medication Practice and Research, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Sha Tin, Hong Kong SAR, China
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - E Y F Wan
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, Centre for Safe Medication Practice and Research, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Sha Tin, Hong Kong SAR, China
| | - C K H Wong
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, Centre for Safe Medication Practice and Research, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Sha Tin, Hong Kong SAR, China
| | - C L Cheung
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, Centre for Safe Medication Practice and Research, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Sha Tin, Hong Kong SAR, China
| | - E W Y Chan
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, Centre for Safe Medication Practice and Research, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Sha Tin, Hong Kong SAR, China
| | - I F N Hung
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - I C K Wong
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, Centre for Safe Medication Practice and Research, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Sha Tin, Hong Kong SAR, China
- Aston Pharmacy School, Aston University, Birmingham, England, UK
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17
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Huang QS, Turner N, Wood T, Anglemyer A, McIntyre P, Aminisani N, Dowell T, Trenholme A, Byrnes C, Balm M, McIntosh C, Jefferies S, Grant CC, Nesdale A, Dobinson HC, Campbell‐Stokes P, Daniells K, Geoghegan J, de Ligt J, Jelley L, Seeds R, Jennings T, Rensburg M, Cueto J, Caballero E, John J, Penghulan E, Tan CE, Ren X, Berquist K, O'Neill M, Marull M, Yu C, McNeill A, Kiedrzynski T, Roberts S, McArthur C, Stanley A, Taylor S, Wong C, Lawrence S, Baker MG, Kvalsvig A, Van Der Werff K, McAuliffe G, Antoszewska H, Dilcher M, Fahey J, Werno A, Elvy J, Grant J, Addidle M, Zacchi N, Mansell C, Widdowson M, Thomas PG, Webby RJ. Impact of the COVID-19 related border restrictions on influenza and other common respiratory viral infections in New Zealand. Influenza Other Respir Viruses 2024; 18:e13247. [PMID: 38350715 PMCID: PMC10864123 DOI: 10.1111/irv.13247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND New Zealand's (NZ) complete absence of community transmission of influenza and respiratory syncytial virus (RSV) after May 2020, likely due to COVID-19 elimination measures, provided a rare opportunity to assess the impact of border restrictions on common respiratory viral infections over the ensuing 2 years. METHODS We collected the data from multiple surveillance systems, including hospital-based severe acute respiratory infection surveillance, SHIVERS-II, -III and -IV community cohorts for acute respiratory infection (ARI) surveillance, HealthStat sentinel general practice (GP) based influenza-like illness surveillance and SHIVERS-V sentinel GP-based ARI surveillance, SHIVERS-V traveller ARI surveillance and laboratory-based surveillance. We described the data on influenza, RSV and other respiratory viral infections in NZ before, during and after various stages of the COVID related border restrictions. RESULTS We observed that border closure to most people, and mandatory government-managed isolation and quarantine on arrival for those allowed to enter, appeared to be effective in keeping influenza and RSV infections out of the NZ community. Border restrictions did not affect community transmission of other respiratory viruses such as rhinovirus and parainfluenza virus type-1. Partial border relaxations through quarantine-free travel with Australia and other countries were quickly followed by importation of RSV in 2021 and influenza in 2022. CONCLUSION Our findings inform future pandemic preparedness and strategies to model and manage the impact of influenza and other respiratory viral threats.
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Affiliation(s)
- Q. Sue Huang
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | | | - Tim Wood
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Andrew Anglemyer
- Institute of Environmental Science and ResearchWellingtonNew Zealand
- University of OtagoDunedinNew Zealand
| | | | | | | | - Adrian Trenholme
- Te Whatu Ora, Health New Zealand Counties ManukauAucklandNew Zealand
| | - Cass Byrnes
- Te Whatu Ora, Health New Zealand Te Toka Tumai AucklandAucklandNew Zealand
| | - Michelle Balm
- Te Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | | | - Sarah Jefferies
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Cameron C. Grant
- University of AucklandAucklandNew Zealand
- Te Whatu Ora, Health New Zealand Te Toka Tumai AucklandAucklandNew Zealand
| | - Annette Nesdale
- Regional Public HealthTe Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Hazel C. Dobinson
- Te Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Priscilla Campbell‐Stokes
- Regional Public HealthTe Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Karen Daniells
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Jemma Geoghegan
- Institute of Environmental Science and ResearchWellingtonNew Zealand
- University of OtagoDunedinNew Zealand
| | - Joep de Ligt
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Lauren Jelley
- Institute of Environmental Science and ResearchWellingtonNew Zealand
- University of OtagoDunedinNew Zealand
| | - Ruth Seeds
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Tineke Jennings
- Regional Public HealthTe Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Megan Rensburg
- Regional Public HealthTe Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Jort Cueto
- Regional Public HealthTe Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Ernest Caballero
- Regional Public HealthTe Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Joshma John
- Regional Public HealthTe Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Emmanuel Penghulan
- Regional Public HealthTe Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Chor Ee Tan
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Xiaoyun Ren
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Klarysse Berquist
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Meaghan O'Neill
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Maritza Marull
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Chang Yu
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Andrea McNeill
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Tomasz Kiedrzynski
- Te Pou Hauora Tūmatanui, the Public Health AgencyManatū Hauora, Ministry of HealthWellingtonNew Zealand
| | - Sally Roberts
- Te Whatu Ora, Health New Zealand Te Toka Tumai AucklandAucklandNew Zealand
| | - Colin McArthur
- Te Whatu Ora, Health New Zealand Te Toka Tumai AucklandAucklandNew Zealand
| | - Alicia Stanley
- Te Whatu Ora, Health New Zealand Te Toka Tumai AucklandAucklandNew Zealand
| | - Susan Taylor
- Te Whatu Ora, Health New Zealand Counties ManukauAucklandNew Zealand
| | - Conroy Wong
- Te Whatu Ora, Health New Zealand Counties ManukauAucklandNew Zealand
| | - Shirley Lawrence
- Te Whatu Ora, Health New Zealand Counties ManukauAucklandNew Zealand
| | | | | | - Koen Van Der Werff
- Te Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Gary McAuliffe
- Te Whatu Ora, Health New Zealand Te Toka Tumai AucklandAucklandNew Zealand
| | - Hanna Antoszewska
- Te Whatu Ora, Health New Zealand Te Toka Tumai AucklandAucklandNew Zealand
| | - Meik Dilcher
- Te Whatu Ora, Health New Zealand Waitaha CanterburyChristchurchNew Zealand
| | - Jennifer Fahey
- Te Whatu Ora, Health New Zealand Waitaha CanterburyChristchurchNew Zealand
| | - Anja Werno
- Te Whatu Ora, Health New Zealand Waitaha CanterburyChristchurchNew Zealand
| | - Juliet Elvy
- Southern Community LaboratoriesDunedinNew Zealand
| | - Jenny Grant
- Southern Community LaboratoriesDunedinNew Zealand
| | - Michael Addidle
- Te Whatu Ora, Health New Zealand Hauora a Toi Bay of PlentyTaurangaNew Zealand
| | - Nicolas Zacchi
- Te Whatu Ora, Health New Zealand Hauora a Toi Bay of PlentyTaurangaNew Zealand
| | - Chris Mansell
- Te Whatu Ora, Health New Zealand WaikatoHamiltonNew Zealand
| | | | - Paul G. Thomas
- WHO Collaborating CentreSt Jude Children's Research HospitalMemphisTennesseeUSA
| | - BorderRestrictionImpactOnFluRSV Consortium
- Institute of Environmental Science and ResearchWellingtonNew Zealand
- Te Whatu Ora, Health New Zealand Counties ManukauAucklandNew Zealand
- Te Whatu Ora, Health New Zealand Te Toka Tumai AucklandAucklandNew Zealand
- Regional Public HealthTe Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
- Te Whatu Ora, Health New Zealand Waitaha CanterburyChristchurchNew Zealand
| | - Richard J. Webby
- WHO Collaborating CentreSt Jude Children's Research HospitalMemphisTennesseeUSA
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18
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Chao S, Wang Y, Wu B, Li R, Dong J, Ji L, Li X, Li R, Yin X, Zhao X, Liang W. Characterization of viral infections in children with influenza-like-illness during December 2018-January 2019. Front Cell Infect Microbiol 2024; 13:1351814. [PMID: 38304460 PMCID: PMC10830827 DOI: 10.3389/fcimb.2023.1351814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 12/26/2023] [Indexed: 02/03/2024] Open
Abstract
Introduction Respiratory viral infection (RVI) is of very concern after the outbreak of COVID-19, especially in pediatric departments. Learning pathogen spectrum of RVI in children previous the epidemic of COVID-19 could provide another perspective for understanding RVI under current situation and help to prepare for the post COVID-19 infection control. Methods A nucleic acid sequence-based amplification (NASBA) assay, with 19 pairs of primers targeting various respiratory viruses, was used for multi-pathogen screening of viral infections in children presenting influenza-like illness (ILI) symptoms. Children with ILI at the outpatient department of Beijing Tsinghua Changgung Hospital during the influenza epidemic from 12/2018 to 01/2019 were included. Throat swabs were obtained for both the influenza rapid diagnostic test (IRDT) based on the colloidal gold immunochromatographic assay and the NASBA assay, targeting various respiratory viruses with an integrated chip technology. Results and discussion Of 519 patients, 430 (82.9%) were positive in the NASBA assay. The predominant viral pathogens were influenza A H1N1 pdm1/2009 (pH1N1) (48.4%) and influenza A (H3N2) (18.1%), followed by human metapneumovirus (hMPV) (8.8%) and respiratory syncytial virus (RSV) (6.1%). Of the 320 cases identified with influenza A by NASBA, only 128 (40.0%) were positive in the IRDT. The IRDT missed pH1N1 significantly more frequently than A (H3N2) (P<0.01). Influenza A pH1N1 and A (H3N2) were the major pathogens in <6 years and 6-15 years old individuals respectively (P<0.05). In summary, influenza viruses were the major pathogens in children with ILI during the 2018-2019 winter influenza epidemic, while hMPV and RSV were non-negligible. The coexistence of multiple pathogen leading to respiratory infections is the normalcy in winter ILI cases.
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Affiliation(s)
- Shuang Chao
- Department of Pediatrics, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Yuejiao Wang
- Department of Pediatrics, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Baolei Wu
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Runqing Li
- Department of Clinical Laboratory, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Jingxiao Dong
- Department of Clinical Laboratory, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Lina Ji
- Department of Pediatrics, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Xuejun Li
- Department of Pediatrics, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Ran Li
- Department of Pediatrics, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Xiaomei Yin
- Department of Pediatrics, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Xiuying Zhao
- Department of Clinical Laboratory, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Wannian Liang
- Vanke School of Public Health, Tsinghua University, Beijing, China
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19
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Yuan J, Xu Y, Wong IOL, Lam WWT, Ni MY, Cowling BJ, Liao Q. Dynamic predictors of COVID-19 vaccination uptake and their interconnections over two years in Hong Kong. Nat Commun 2024; 15:290. [PMID: 38177142 PMCID: PMC10767005 DOI: 10.1038/s41467-023-44650-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024] Open
Abstract
The global rollout of COVID-19 vaccines faces a significant barrier in the form of vaccine hesitancy. This study adopts a dynamic and network perspective to explore the determinants of COVID-19 vaccine uptake in Hong Kong, focusing on multi-level determinants and their interconnections. Following the framework proposed by the Strategic Advisory Group of Experts (SAGE), the study used repeated cross-sectional surveys to map these determinants at multiple levels and investigates their interconnections simultaneously in a sample of 15,179 over two years. The results highlight the dynamic nature of COVID-19 vaccine hesitancy in an evolving pandemic. The findings suggest that vaccine confidence attitudes play crucial roles in vaccination uptake, with their importance shifting over time. The initial emphasis on vaccine safety gradually transitioned to heightened consideration of vaccine effectiveness at a later stage. The study also highlights the impact of chronic condition, age, COVID-19 case numbers, and non-pharmaceutical preventive behaviours on vaccine uptake. Higher educational attainment and being married were associated with primary and booster vaccine uptake and it may be possible to leverage these groups as early innovation adopters. Trust in government acts as a crucial bridging factor linking various variables in the networks with vaccine confidence attitudes, which subsequently closely linked to vaccine uptake. This study provides insights for designing future effective vaccination programmes for changing circumstances.
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Affiliation(s)
- Jiehu Yuan
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Yucan Xu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Irene Oi Ling Wong
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Wendy Wing Tak Lam
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Li Ka Shing Faculty of Medicine, Jocky Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, China
| | - Michael Y Ni
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China
- Urban Systems Institute, The University of Hong Kong, Hong Kong, China
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
- Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, New Territories, Hong Kong, China.
| | - Qiuyan Liao
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
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20
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Yip KM, Wong SWS, So HK, Tso WWY, Siu PMF, Wong ICK, Yam JC, Kwan MYW, Lum TYS, Louie LHT, Lee A, Wong WHS, Ip P. Physical Fitness and Body Mass Index Status of Hong Kong Primary Schoolchildren across the COVID-19 Pandemic, before and after School Closure. J Pediatr 2024; 264:113729. [PMID: 37722554 DOI: 10.1016/j.jpeds.2023.113729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/05/2023] [Accepted: 09/13/2023] [Indexed: 09/20/2023]
Abstract
OBJECTIVE To determine whether health-related physical fitness and body mass index (BMI) status differed before and after school closure from the COVID-19 pandemic in a population-based cohort of Hong Kong primary schoolchildren. STUDY DESIGN We examined the BMI z score, BMI status, and physical fitness z scores including (i) upper limb muscle strength, (ii) 1-minute sit-up test, (iii) sit-and-reach test, and (iv) endurance run tests, among 3 epochs: prepandemic (September 2018-August 2019), before school closure (September 2019-January 2020), and partial school reopening (September 2021-August 2022), using a repeated cross-sectional approach. RESULTS A total of 137 752 primary schoolchildren aged 6-12 years were recruited over 3 academic years. Obesity increased significantly from 25.9% in 2018/19 to 31.0% in 2021/22, while underweight increased slightly from 6.1% to 6.5%. All tested parameters were adversely affected by the pandemic. The negative trend over time was far more pronounced in all 4 physical fitness scores in the underweight group, although performance in handgrip strength had no significance between 2018/19 and 2021/22. CONCLUSIONS Schoolchildren who are both underweight and overweight/obese are vulnerable to adverse changes in physical fitness during the COVID-19 pandemic. To eliminate the negative health and fitness outcomes, it is urgent to develop strategies for assisting schoolchildren in achieving a healthy weight, especially in the postpandemic era.
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Affiliation(s)
- Ka-Man Yip
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Sam W S Wong
- Physical Fitness Association of Hong Kong, Hong Kong SAR, China
| | - Hung-Kwan So
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Winnie W Y Tso
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Parco M F Siu
- School of Public Health, The University of Hong Kong Hong Kong SAR, China
| | - Ian C K Wong
- Department of Pharmacology and Pharmacy, Centre for Safe Medication Practice and Research, The University of Hong Kong, Hong Kong SAR, China
| | - Jason C Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Mike Y W Kwan
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong SAR, China
| | - Terry Y S Lum
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Lobo H T Louie
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Albert Lee
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China; School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wilfred H S Wong
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China; Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong SAR, China.
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21
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Liu J, Ouyang N, Mizrahi A, Kornides ML. Social Distancing in the COVID-19 Pandemic: Associated Factors, Health Outcomes, and Implications. FAMILY & COMMUNITY HEALTH 2024; 47:80-94. [PMID: 37681938 DOI: 10.1097/fch.0000000000000367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
Social distancing has reemerged as a public health measure for containing the spread of COVID-19. This integrative review aims to analyze the historical use of social distancing, the current application during COVID-19, individual factors that affect social distancing practices, and consequential health outcomes. We analyzed relevant literature from searches conducted on Scopus, PubMed, and PsycINFO. We found that resources, culture, age, gender, and personality are associated with the degree to which people practice social distancing. Furthermore, social distancing changes our lifestyles and behavior and results in multifaceted health outcomes, including decreased physical activity and sunlight exposure, increased weight gain, and impaired sleep quality. On the positive side, social distancing has been linked to reduced crime rates and environmental damage, as well as better social and family ties. Future interventions may be utilized to increase adherence to social distancing practices and to mitigate the negative health effects of social distancing.
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Affiliation(s)
- Jianghong Liu
- Department of Family and Community Health, School of Nursing (Dr Liu), School of Nursing (Ms Ouyang and Dr Kornides), School of Arts and Sciences (Ms Mizrahi), University of Pennsylvania, Philadelphia; and Yale University, New Haven, Connecticut (Ms Ouyang)
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22
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Feindouno S, Arcand JL, Guillaumont P. COVID-19's death transfer to Sub-Saharan Africa. Soc Sci Med 2024; 340:116486. [PMID: 38141493 DOI: 10.1016/j.socscimed.2023.116486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/26/2023] [Accepted: 11/29/2023] [Indexed: 12/25/2023]
Abstract
The COVID-19 spread very quickly around the world following its discovery in China, in December 2019. Lockdowns implemented in China and the Global North to control the propagation of the virus and to save human lives have resulted in a global recession. The transmission of the recessionary effects from the Global North to the Global South is reflected in the decline in sub-Saharan Africa's (SSA) GDP and the associated increase in poverty. The purpose of this paper is to illustrate how the recession induced in China and the Global North by COVID-19 lockdowns may have had indirect effects on SSA mortality that are higher than those directly attributed to the pandemic itself. Our methodology relies on a three-step relationship: (i) the impact of lockdowns on the recession in the North, (ii) the impact of the recession in the North on income in SSA countries, and (iii) the impact of a decline in income on mortality in SSA. We show that COVID-19-induced lockdowns in the Global North, through the severe recessions they induced in the Global South, resulted in the transfer of between 538,000 and 679,000 deaths in one year to SSA, including the deaths of 140,000 to 177,000 children aged 0-5 years. This corresponds to a 6-7% increase in the crude death rate and a 5-6% increase in under-5 mortality. These figures are much higher than the number of deaths directly attributable to COVID-19 in SSA. Thus, policymakers must not lose sight of the indirect excess mortality caused by global economic recession triggered by the pandemic. Our results reveal the need to increase the resilience of SSA countries to exogenous shocks, including COVID-19, which, in addition to increasing poverty, may induce excessive mortality due to the high sensitivity of mortality in SSA countries to economic recession.
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Affiliation(s)
| | - Jean-Louis Arcand
- FERDI, Clermont Ferrand, France; The Graduate Institute, Geneva, Switzerland.
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23
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Hu L, Yang Y, Lin J, Yan Q, Sun C, Li Z, Sun L, Xu J, Chen J, Bai G. Epidemiological characteristics of respiratory syncytial virus infection in pediatric patients before, during the COVID-19 pandemic and after easing of COVID-19 restrictive measures in China. J Med Virol 2024; 96:e29374. [PMID: 38197487 DOI: 10.1002/jmv.29374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/07/2023] [Accepted: 12/25/2023] [Indexed: 01/11/2024]
Abstract
We aimed to assess the epidemiological characteristics of respiratory syncytial virus (RSV) infection in Chinese children at different phases of the coronavirus disease 2019 (COVID-19) pandemic, that is, before, during the pandemic and after easing of restrictive measures. We included 123 623 patients aged 0-18 years with respiratory infection symptoms who were suspected with RSV infection from January 1, 2019 to June 30, 2023 in Hangzhou Children's Hospital. Clinical information and RSV test result were extracted from the laboratory information system. We calculated the positive rate of RSV detection by age groups, gender, seasons, types of patients and phases of COVID-19 pandemic. Nonlinear associations between age and risk of RSV infection in three phases of pandemic were assessed by restricted cubic spline regression models. Among 123 623 patients, 3875 (3.13%) were tested as positive. The highest positive rate was observed in children aged 0-28 days (i.e., 12.28%). RSV infection was most prevalent in winter (6.04%), and followed by autumn (2.52%). Although there is no statistical significance regarding the positive rate at three phases of the pandemic, we observed that the rate was lowest during the pandemic and increased after easing the measures in certain age groups (p < 0.05), which was consisted with results from the nonlinear regression analyses. In addition, regression analyses suggested that the age range of children susceptible to RSV got wider, that is, 0-3.5 years, after easing all restrictive measures compared with that before (i.e., 0-3 years) and during the pandemic (i.e., 0-1 year). Based on our findings, we called for attention from health professionals and caregivers on the new epidemiological characteristics of RSV infection in the post-pandemic era after easing the restrictive measures.
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Affiliation(s)
- Lidan Hu
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Yang Yang
- Yunnan Provincial Key Laboratory of Public Health and Biosafety & School of Public Health, Kunming, China
| | - Jianyu Lin
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Qingtao Yan
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Changxuan Sun
- Dushu Lake Hospital Affiliated to Soochow University, Medical Center of Soochow University, Suzhou Dushu Lake Hospital, Suzhou, Jiangshu, China
| | - Ziqiao Li
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Lidan Sun
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Jingfang Xu
- Department of Orthopedics, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Jie Chen
- Department of Respiratory, Hangzhou Children's Hospital, Hangzhou, Zhejiang, China
| | - Guannan Bai
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
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24
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Cheng HY, Liu DP. Early Prompt Response to COVID-19 in Taiwan: Comprehensive surveillance, decisive border control, and information technology support. J Formos Med Assoc 2024; 123 Suppl 1:S2-S7. [PMID: 36424239 PMCID: PMC9650562 DOI: 10.1016/j.jfma.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 11/03/2022] [Accepted: 11/06/2022] [Indexed: 11/13/2022] Open
Abstract
Since the COVID-19 outbreak was detected in Wuhan in December 2019 by the event-based surveillance of Taiwan Centers for Disease Control, Taiwan has been aligning risk management to policy planning with the assistance of comprehensive surveillance and regular rapid risk assessments. Taiwan Central Epidemic Command Center (CECC) promptly initiated stepwise border control for major cities and provinces in China, European and American countries, and eventually expanded it to the whole world in March 2020. With stringent quarantine measures, the early response not only successfully blocked the first wave of imported cases, but also slowed down subsequent large local outbreaks. Digital technologies including digital fencing and government database linkage were adopted to facilitate the application of public health interventions and data collection. The experience of Taiwan's prompt and comprehensive response at the early stage may contribute to the preparedness for the next disease X outbreak.
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Affiliation(s)
- Hao-Yuan Cheng
- Epidemic Intelligence Center, Taiwan Centers for Disease Control, Taipei, Taiwan
| | - Ding-Ping Liu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
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25
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Gertz A, Rader B, Sewalk K, Varrelman TJ, Smolinski M, Brownstein JS. Decreased Seasonal Influenza Rates Detected in a Crowdsourced Influenza-Like Illness Surveillance System During the COVID-19 Pandemic: Prospective Cohort Study. JMIR Public Health Surveill 2023; 9:e40216. [PMID: 38153782 PMCID: PMC10784978 DOI: 10.2196/40216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/24/2023] [Accepted: 11/14/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND Seasonal respiratory viruses had lower incidence during their 2019-2020 and 2020-2021 seasons, which overlapped with the COVID-19 pandemic. The widespread implementation of precautionary measures to prevent transmission of SARS-CoV-2 has been seen to also mitigate transmission of seasonal influenza. The COVID-19 pandemic also led to changes in care seeking and access. Participatory surveillance systems have historically captured mild illnesses that are often missed by surveillance systems that rely on encounters with a health care provider for detection. OBJECTIVE This study aimed to assess if a crowdsourced syndromic surveillance system capable of detecting mild influenza-like illness (ILI) also captured the globally observed decrease in ILI in the 2019-2020 and 2020-2021 influenza seasons, concurrent with the COVID-19 pandemic. METHODS Flu Near You (FNY) is a web-based participatory syndromic surveillance system that allows participants in the United States to report their health information using a brief weekly survey. Reminder emails are sent to registered FNY participants to report on their symptoms and the symptoms of household members. Guest participants may also report. ILI was defined as fever and sore throat or fever and cough. ILI rates were determined as the number of ILI reports over the total number of reports and assessed for the 2016-2017, 2017-2018, 2018-2019, 2019-2020, and 2020-2021 influenza seasons. Baseline season (2016-2017, 2017-2018, and 2018-2019) rates were compared to the 2019-2020 and 2020-2021 influenza seasons. Self-reported influenza diagnosis and vaccination status were captured and assessed as the total number of reported events over the total number of reports submitted. CIs for all proportions were calculated via a 1-sample test of proportions. RESULTS ILI was detected in 3.8% (32,239/848,878) of participants in the baseline seasons (2016-2019), 2.58% (7418/287,909) in the 2019-2020 season, and 0.27% (546/201,079) in the 2020-2021 season. Both influenza seasons that overlapped with the COVID-19 pandemic had lower ILI rates than the baseline seasons. ILI decline was observed during the months with widespread implementation of COVID-19 precautions, starting in February 2020. Self-reported influenza diagnoses decreased from early 2020 through the influenza season. Self-reported influenza positivity among ILI cases varied over the observed time period. Self-reported influenza vaccination rates in FNY were high across all observed seasons. CONCLUSIONS A decrease in ILI was detected in the crowdsourced FNY surveillance system during the 2019-2020 and 2020-2021 influenza seasons, mirroring trends observed in other influenza surveillance systems. Specifically, the months within seasons that overlapped with widespread pandemic precautions showed decreases in ILI and confirmed influenza. Concerns persist regarding respiratory pathogens re-emerging with changes to COVID-19 guidelines. Traditional surveillance is subject to changes in health care behaviors. Systems like FNY are uniquely situated to detect disease across disease severity and care seeking, providing key insights during public health emergencies.
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Affiliation(s)
- Autumn Gertz
- Computational Epidemiology Lab, Boston Children's Hospital, Boston, MA, United States
| | - Benjamin Rader
- Computational Epidemiology Lab, Boston Children's Hospital, Boston, MA, United States
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
| | - Kara Sewalk
- Computational Epidemiology Lab, Boston Children's Hospital, Boston, MA, United States
| | - Tanner J Varrelman
- Computational Epidemiology Lab, Boston Children's Hospital, Boston, MA, United States
| | | | - John S Brownstein
- Computational Epidemiology Lab, Boston Children's Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
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26
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Juneau CE, Briand AS, Collazzo P, Siebert U, Pueyo T. Effective contact tracing for COVID-19: A systematic review. GLOBAL EPIDEMIOLOGY 2023; 5:100103. [PMID: 36959868 PMCID: PMC9997056 DOI: 10.1016/j.gloepi.2023.100103] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/19/2023] [Accepted: 03/06/2023] [Indexed: 03/11/2023] Open
Abstract
Contact tracing is commonly recommended to control outbreaks of COVID-19, but its effectiveness is unclear. Following PRISMA guidelines, we searched four databases using a range of terms related to contact tracing effectiveness for COVID-19. We found 343 papers; 32 were included. All were observational or modelling studies. Observational studies (n = 14) provided consistent, very-low certainty evidence that contact tracing (alone or in combination with other interventions) was associated with better control of COVID-19 (e.g. in Hong Kong, only 1084 cases and four deaths were recorded in the first 4.5 months of the pandemic). Modelling studies (n = 18) provided consistent, high-certainty evidence that under assumptions of prompt and thorough tracing with effective quarantines, contact tracing could stop the spread of COVID-19 (e.g. by reducing the reproduction number from 2.2 to 0.57). A cautious interpretation indicates that to stop the spread of COVID-19, public health practitioners have 2-3 days from the time a new case develops symptoms to isolate the case and quarantine at least 80% of its contacts.
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Affiliation(s)
- Carl-Etienne Juneau
- Direction régionale de santé publique, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
| | - Anne-Sara Briand
- École de santé publique, Université de Montréal, Montréal, Québec, Canada
| | - Pablo Collazzo
- Danube University Krems, Dr. Karl Dorrek-Strasse 30, 3500 Krems, Austria and IEEM Universidad de Montevideo, Lord Ponsonby 2542, 16000 Montevideo, Uruguay
| | - Uwe Siebert
- Institute for Technology Assessment, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Austria
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27
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Xiong W, Cowling BJ, Tsang TK. Influenza Resurgence after Relaxation of Public Health and Social Measures, Hong Kong, 2023. Emerg Infect Dis 2023; 29:2556-2559. [PMID: 37885047 PMCID: PMC10683823 DOI: 10.3201/eid2912.230937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023] Open
Abstract
Soon after a mask mandate was relaxed (March 1, 2023), the first post-COVID-19 influenza season in Hong Kong lasted 12 weeks. After other preventive measures were accounted for, mask wearing was associated with an estimated 25% reduction in influenza transmission. Influenza resurgence probably resulted from relaxation of mask mandates and other measures.
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28
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Beekman ATF. How Do Older People Fare in Times of Violence and Social Unrest? Am J Geriatr Psychiatry 2023; 31:1100-1101. [PMID: 37481401 DOI: 10.1016/j.jagp.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 07/24/2023]
Affiliation(s)
- Aartjan T F Beekman
- Department of Psychiatry, Vrije Universiteit and Amsterdam University Medical Center, Amsterdam, Netherlands.
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29
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Sunagawa J, Park H, Kim KS, Komorizono R, Choi S, Ramirez Torres L, Woo J, Jeong YD, Hart WS, Thompson RN, Aihara K, Iwami S, Yamaguchi R. Isolation may select for earlier and higher peak viral load but shorter duration in SARS-CoV-2 evolution. Nat Commun 2023; 14:7395. [PMID: 37989736 PMCID: PMC10663562 DOI: 10.1038/s41467-023-43043-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 10/30/2023] [Indexed: 11/23/2023] Open
Abstract
During the COVID-19 pandemic, human behavior change as a result of nonpharmaceutical interventions such as isolation may have induced directional selection for viral evolution. By combining previously published empirical clinical data analysis and multi-level mathematical modeling, we find that the SARS-CoV-2 variants selected for as the virus evolved from the pre-Alpha to the Delta variant had earlier and higher peak in viral load dynamics but a shorter duration of infection. Selection for increased transmissibility shapes the viral load dynamics, and the isolation measure is likely to be a driver of these evolutionary transitions. In addition, we show that a decreased incubation period and an increased proportion of asymptomatic infection are also positively selected for as SARS-CoV-2 mutated to adapt to human behavior (i.e., Omicron variants). The quantitative information and predictions we present here can guide future responses in the potential arms race between pandemic interventions and viral evolution.
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Affiliation(s)
- Junya Sunagawa
- Department of Advanced Transdisciplinary Sciences, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Hyeongki Park
- interdisciplinary Biology Laboratory (iBLab), Division of Natural Science, Graduate School of Science, Nagoya University, Nagoya, Japan
| | - Kwang Su Kim
- interdisciplinary Biology Laboratory (iBLab), Division of Natural Science, Graduate School of Science, Nagoya University, Nagoya, Japan
- Department of Scientific Computing, Pukyong National University, Busan, South Korea
- Department of Mathematics, Pusan National University, Busan, South Korea
| | - Ryo Komorizono
- Laboratory of RNA Viruses, Department of Virus Research, Institute for Life and Medical Sciences (LiMe), Kyoto University, Kyoto, Japan
| | - Sooyoun Choi
- interdisciplinary Biology Laboratory (iBLab), Division of Natural Science, Graduate School of Science, Nagoya University, Nagoya, Japan
- Department of Mathematics, Pusan National University, Busan, South Korea
| | - Lucia Ramirez Torres
- interdisciplinary Biology Laboratory (iBLab), Division of Natural Science, Graduate School of Science, Nagoya University, Nagoya, Japan
| | - Joohyeon Woo
- interdisciplinary Biology Laboratory (iBLab), Division of Natural Science, Graduate School of Science, Nagoya University, Nagoya, Japan
| | - Yong Dam Jeong
- interdisciplinary Biology Laboratory (iBLab), Division of Natural Science, Graduate School of Science, Nagoya University, Nagoya, Japan
- Department of Mathematics, Pusan National University, Busan, South Korea
| | - William S Hart
- Mathematical Institute, University of Oxford, Oxford, UK
| | - Robin N Thompson
- Mathematical Institute, University of Oxford, Oxford, UK
- Mathematics Institute, University of Warwick, Coventry, UK
- Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research, University of Warwick, Coventry, UK
| | - Kazuyuki Aihara
- International Research Center for Neurointelligence, The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Tokyo, Japan
| | - Shingo Iwami
- interdisciplinary Biology Laboratory (iBLab), Division of Natural Science, Graduate School of Science, Nagoya University, Nagoya, Japan.
- Institute of Mathematics for Industry, Kyushu University, Fukuoka, Japan.
- Institute for the Advanced Study of Human Biology (ASHBi), Kyoto University, Kyoto, Japan.
- Interdisciplinary Theoretical and Mathematical Sciences Program (iTHEMS), RIKEN, Saitama, Japan.
- NEXT-Ganken Program, Japanese Foundation for Cancer Research (JFCR), Tokyo, Japan.
- Science Groove Inc, Fukuoka, Japan.
| | - Ryo Yamaguchi
- Department of Advanced Transdisciplinary Sciences, Hokkaido University, Sapporo, Hokkaido, Japan.
- Department of Zoology & Biodiversity Research Centre, University of British Columbia, Vancouver, BC, Canada.
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30
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Blais JE, Zhang W, Lin Y, Chui CSL, Cheng VCC, Cowling BJ, Wu P. Antibiotic use in hospitalized patients with COVID-19: a population-based study in Hong Kong. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2023; 3:e205. [PMID: 38028893 PMCID: PMC10654948 DOI: 10.1017/ash.2023.485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/03/2023] [Accepted: 10/04/2023] [Indexed: 12/01/2023]
Abstract
Background Hong Kong experienced four epidemic waves caused by the ancestral strain of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 2020-2021 and a large Omicron wave in 2022. Few studies have assessed antibacterial prescribing for coronavirus disease 2019 (COVID-19) inpatients throughout the pandemic. Objectives To describe inpatient antibacterial prescribing and explore factors associated with their prescription. Methods Electronic health records of patients with COVID-19 admitted to public hospitals in Hong Kong from 21 January 2020 to 30 September 2022 were used to assess the prevalence and rates of inpatient antibacterial drug use (days of therapy/1,000 patient days [DOT/1,000 PD]). We used multivariable logistic regression to investigate potential associations between patients' baseline characteristics and disease severity and prescription of an antibacterial drug during hospital admission. Results Among 65,810 inpatients with COVID-19, 54.0% were prescribed antibacterial drugs (550.5 DOT/1,000 PD). Compared to waves 1-2 (46.7%; 246.9 DOT/1,000 PD), the prescriptions were lowest during wave 4 (28.0%; 246.9; odds ratio (OR): 0.39, 95% CI: 0.31-0.49) and peaked in early wave 5 (64.6%; 661.2; 0.82, 0.65-1.03). Older age (≥80 years: OR 2.66, 95% CI, 2.49-2.85; 60-79 years: 1.59, 1.51-1.69, compared with 20-59 years), more severe disease (fatal: 3.64, 3.2-4.16; critical: 2.56, 2.14-3.06, compared with severe), and COVID-19 vaccine doses (two doses: 0.74, 0.69-0.78; three doses: 0.69, 0.64-0.74; four doses: 0.52, 0.44-0.62, compared with unvaccinated) were associated with inpatient antibacterial drug use. Conclusions Antibacterial prescribing changed over time for hospitalized patients with confirmed COVID-19 and was potentially related to patients' demographics, medical conditions, and COVID-19 vaccination status as well as healthcare capacity during epidemic waves.
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Affiliation(s)
- Joseph Edgar Blais
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administration Region, China
- Laboratory of Data Discovery for Health (D4H), Hong Kong Science Park, Hong Kong Science and Technology Park, Hong Kong Special Administration Region, China
| | - Weixin Zhang
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administration Region, China
| | - Yun Lin
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administration Region, China
| | - Celine SL Chui
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administration Region, China
- Laboratory of Data Discovery for Health (D4H), Hong Kong Science Park, Hong Kong Science and Technology Park, Hong Kong Special Administration Region, China
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administration Region, China
| | - Vincent Chi-Chung Cheng
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administration Region, China
| | - Benjamin John Cowling
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administration Region, China
- Laboratory of Data Discovery for Health (D4H), Hong Kong Science Park, Hong Kong Science and Technology Park, Hong Kong Special Administration Region, China
| | - Peng Wu
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administration Region, China
- Laboratory of Data Discovery for Health (D4H), Hong Kong Science Park, Hong Kong Science and Technology Park, Hong Kong Special Administration Region, China
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31
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Prins H, Dörre A, Schmidt D. Statutory health insurance-covered pre-exposure prophylaxis in Germany: changing trends in nationwide tenofovir disoproxil/emtricitabine prescriptions during the COVID-19 pandemic. Front Pharmacol 2023; 14:1241310. [PMID: 38026934 PMCID: PMC10654745 DOI: 10.3389/fphar.2023.1241310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Background: In 2019, Germany introduced a law to reimburse high-incidence populations for pre-exposure prophylaxis (PrEP), prescribed as tenofovir-disoproxil/emtricitabine (TDF/FTC), via statutory health insurance (SHI). We studied changes in TDF/FTC-prescriptions after the implementation of this law and during the COVID-19 pandemic. Methods: We performed an interrupted time series analysis with monthly prescriptions per defined time period as the outcome. We considered the introduction of SHI-covered PrEP (09/2019) as an interruption, and four COVID-19 waves and two national lockdowns (2020-2021) as explanatory variables. We extrapolated prescriptions had the lockdowns not occurred, and compared this to the actual prescriptions. We performed sub-analyses based on stratification by five federal states with the highest proportion of PrEP users. We assessed the models' goodness-of-fit based on the adjusted R-squared using RStudio. Results: The best fitting model included SHI-covered PrEP and the first COVID-19 lockdown (04/2020). The decrease in prescriptions during the first lockdown was significant nationally, and in the five federal states for single-month prescriptions. The first lockdown resulted in reductions of 57.7% (95% prediction interval (PI): 23.0%-92.4%) for single-month prescriptions, while 17.4% (95% PI: 0.28%-34.5%) nationally, and 13.9% (95% PI: -3.67%-31.5%) for 3-month prescriptions. Conclusion: Introduction of SHI-covered PrEP resulted in a doubling of TDF/FTC-prescriptions nationwide in the first month alone. A drop in prescriptions was most apparent after the first lockdown, and particularly affected PrEP initiations, possibly due to reduced healthcare access and behavioural changes. Ongoing monitoring of TDF/FTC-prescriptions is needed to safeguard access to preventative care such as PrEP and particularly PrEP initiation during public health crises like COVID-19.
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Affiliation(s)
- Henrieke Prins
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
- ECDC Fellowship Programme, Field Epidemiology Path (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Achim Dörre
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Daniel Schmidt
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
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Wong JY, Cheung JK, Lin Y, Bond HS, Lau EHY, Ip DKM, Cowling BJ, Wu P. Intrinsic and Effective Severity of Coronavirus Disease 2019 Cases Infected With the Ancestral Strain and Omicron BA.2 Variant in Hong Kong. J Infect Dis 2023; 228:1231-1239. [PMID: 37368235 DOI: 10.1093/infdis/jiad236] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/25/2023] [Accepted: 06/23/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Understanding severity of infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its variants is crucial to inform public health measures. Here we used coronavirus disease 2019 (COVID-19) patient data from Hong Kong to characterize the severity profile of COVID-19. METHODS Time-varying and age-specific effective severity measured by case hospitalization risk and hospitalization fatality risk was estimated with all individual COVID-19 case data collected in Hong Kong from 23 January 2020 through 26 October 2022 over 6 epidemic waves. The intrinsic severity of Omicron BA.2 was compared with the estimate for the ancestral strain with the data from unvaccinated patients without previous infections. RESULTS With 32 222 COVID-19 hospitalizations and 9669 deaths confirmed over 6 epidemic waves, the time-varying hospitalization fatality risk dramatically increased from <10% before the largest fifth wave of Omicron BA.2 to 41% during the peak of the fifth wave when hospital resources were severely constrained. The age-specific fatality risk in unvaccinated hospitalized Omicron cases was comparable to the estimates for unvaccinated cases with the ancestral strain. During epidemics predominated by Omicron BA.2, fatality risk was highest among older unvaccinated patients. CONCLUSIONS Omicron has comparable intrinsic severity to the ancestral Wuhan strain, although the effective severity is substantially lower in Omicron cases due to vaccination.
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Affiliation(s)
- Jessica Y Wong
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Justin K Cheung
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Yun Lin
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Helen S Bond
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Eric H Y Lau
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, New Territories, Hong Kong Special Administrative Region, China
| | - Dennis K M Ip
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Benjamin J Cowling
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, New Territories, Hong Kong Special Administrative Region, China
| | - Peng Wu
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, New Territories, Hong Kong Special Administrative Region, China
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Panagiotidis T, Papapanagiotou G, Stengos T. Dying together: A convergence analysis of fatalities during COVID-19. JOURNAL OF ECONOMIC ASYMMETRIES 2023; 28:e00315. [PMID: 37389328 PMCID: PMC10290892 DOI: 10.1016/j.jeca.2023.e00315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 05/08/2023] [Accepted: 05/24/2023] [Indexed: 07/01/2023]
Abstract
Governments implemented countermeasures to mitigate the spread of the COVID-19 virus. This had a severe effect on the economy. We examine convergence patterns in the evolution of COVID-19 deaths across countries. We aim to investigate whether countries that implemented different measures managed to limit the number of COVID-19 deaths. We extend the most recent macro-growth convergence methodology to examine convergence of COVID-19 deaths. We combine a long memory stationarity framework with the maximal clique algorithm. This provides a rich and flexible club formation strategy that goes beyond the stationary/non stationary approach adopted in the previous literature. Our results suggest that strict measures (even belated) or an aggressive vaccination scheme can confine the spread of the disease while maintaining the strictness of the measures steady can lead to a burst of the virus. Finally, we observe that fiscal measures did not have an effect on the containment of the virus.
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Affiliation(s)
| | | | - Thanasis Stengos
- Department of Economics and Finance, University of Guelph, Canada
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Shi L, Lu J, Sun X, Li Z, Zhang L, Lu Y, Yao Y. Impact of Varicella Immunization and Public Health and Social Measures on Varicella Incidence: Insights from Surveillance Data in Shanghai, 2013-2022. Vaccines (Basel) 2023; 11:1674. [PMID: 38006006 PMCID: PMC10674188 DOI: 10.3390/vaccines11111674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/27/2023] [Accepted: 10/28/2023] [Indexed: 11/26/2023] Open
Abstract
To evaluate the impact of a two-dose VarV program on varicella incidence among the whole population, considering the influence of public health and social measures (PHSMs), we extracted surveillance data on varicella cases during 2013-2022 in Minhang, Shanghai. Then, we estimated the incidence trend of varicella through interrupted time-series analyses and quantified the impact of the immunization program and PHSMs using Serfling regression. We also explored the associations between PHSMs and varicella cases. The implementation of the two-dose VarV strategy was followed by a significant decrease in varicella incidence (-1.84% per month). After one year of the program, varicella incidence was estimated at a 45.25% reduction, which was higher in children (59.12% and 54.09%) than in adults (19.49%). The decrease attributed to PHSMs was 31.26% during 2020-2022, and school closing was identified as the most relevant PHSM (b = -8.03 cases, r = -0.67 with a 1-week lag). These findings indicate that the two-dose immunization program has more effectively reduced the varicella incidence compared with the one-dose vaccine, and interventions like school closings are also encouraged to serve as supplementary measures to prevent varicella epidemics.
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Affiliation(s)
- Liming Shi
- School of Public Health, Fudan University, 131 Dong’an Road, Shanghai 200032, China; (L.S.); (Y.L.)
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, 131 Dong’an Road, Shanghai 200032, China
| | - Jia Lu
- Minhang District Center for Disease Control and Prevention, 965 Zhongyi Road, Shanghai 201101, China; (J.L.); (L.Z.)
| | - Xiaodong Sun
- Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhongshan Road, Shanghai 200336, China; (X.S.); (Z.L.)
| | - Zhi Li
- Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhongshan Road, Shanghai 200336, China; (X.S.); (Z.L.)
| | - Liping Zhang
- Minhang District Center for Disease Control and Prevention, 965 Zhongyi Road, Shanghai 201101, China; (J.L.); (L.Z.)
| | - Yihan Lu
- School of Public Health, Fudan University, 131 Dong’an Road, Shanghai 200032, China; (L.S.); (Y.L.)
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, 131 Dong’an Road, Shanghai 200032, China
| | - Ye Yao
- School of Public Health, Fudan University, 131 Dong’an Road, Shanghai 200032, China; (L.S.); (Y.L.)
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, 131 Dong’an Road, Shanghai 200032, China
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Wei Z, Zhuang J. On the adoption of nonpharmaceutical interventions during the pandemic: An evolutionary game model. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2023; 43:2298-2311. [PMID: 36635059 DOI: 10.1111/risa.14093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The adoption of behavioral nonpharmaceutical interventions (NPIs) among the public is essential for tackling the COVID-19 pandemic, yet presents challenges due to the complexity of human behaviors. A large body of literature has utilized classic game theory to investigate the population's decisions regarding the adoption of interventions, where the static solution concept such as the Nash equilibrium is studied. However, individual adoption behavior is not static, instead it is a dynamic process that involves the strategic interactions with other counterparts over time. The study of quantitatively analyzing the dynamics on precautionary behavior during an outbreak is rather scarce. This article fills the research gap by developing an evolutionary game-theoretic framework to model the dynamics of population behavior on the adoption of NPI. We construct the two-group asymmetric game, where behavioral change for each group is characterized by replicator equations. Sensitivity analyses are performed to examine the long-term stability of equilibrium points with respect to perturbation of model parameters. We found that the limiting behavior of intervention adoption in the population consists of only pure strategies in a game setting, indicating that the evolutionary outcome is that everyone either takes up the preventive measure or not. We also applied the framework to examine the mask-wearing behavior, and validated with actual data. Overall, this article provides insights into population dynamics on the adoption of intervention strategy during the outbreak, which can be beneficial for policy makers to better understand the evolutionary trajectory of population behavior.
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Affiliation(s)
- Zhiyuan Wei
- Department of Industrial and Systems Engineering, University at Buffalo, Buffalo, New York, USA
| | - Jun Zhuang
- Department of Industrial and Systems Engineering, University at Buffalo, Buffalo, New York, USA
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Li Z, Xiong Y, Long J, Li T, Fu X, Yang S, Tian D, Zhao Y, Qi L. Resurgence of influenza during COVID-19 in Chongqing, China: A retrospective analysis. J Med Virol 2023; 95:e29249. [PMID: 38009822 DOI: 10.1002/jmv.29249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 10/12/2023] [Accepted: 11/11/2023] [Indexed: 11/29/2023]
Abstract
To better understand the trends of influenza and the impact of public health and social measures (PHSMs) implemented during the coronavirus disease 2019 (COVID-19) period in Chongqing, China. Data from the China Influenza Surveillance Information System from January 2017 to June 2022 were extracted. Epidemiological characteristics (influenza-like illness [ILI] and ILI%) and virological characteristics (influenza positive rate and circulating (sub)types) of influenza were described and compared between the pre-COVID-19 period and the COVID-19 period. Our survey showed that the implementation of PHSMs during the COVID-19 period had a positive impact on reducing influenza transmission. However, influenza activity resurged in 2021-2022 as the PHSMs were eased. Children under 5 years old constituted the highest proportion of ILI cases. The overall influenza positive rate was 23.70%, with a higher rate observed during the pre-COVID-19 period (31.55%) compared to the COVID-19 period (13.68%). Influenza virus subtypes co-circulated and the predominant subtype varied each year, with influenza A subtypes predominated in 2018/2019, while influenza B/Victoria lineage dominated in 2020/2021. PHSMs are effective measures to mitigate the spread of influenza. The findings underscore the need for bolstering monitoring systems, advocating influenza vaccination, and implementing practical PHSMs to strengthen prevention and control measures against influenza.
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Affiliation(s)
- Zhourong Li
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Yu Xiong
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
- Chongqing Municipal Key Laboratory for High Pathogenic Microbes, Chongqing, China
| | - Jiang Long
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
- Chongqing Municipal Key Laboratory for High Pathogenic Microbes, Chongqing, China
| | - Tingting Li
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
- Chongqing Municipal Key Laboratory for High Pathogenic Microbes, Chongqing, China
| | - Xiaoqing Fu
- Southwest Medical University, Sichuan, China
| | - Shuang Yang
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Dechao Tian
- Department of Biostatistics and Systems Biology, School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Yong Zhao
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Li Qi
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
- Chongqing Municipal Key Laboratory for High Pathogenic Microbes, Chongqing, China
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Tang M, Dong W, Yuan S, Chen J, Lin J, Wu J, Zhang J, Yin Y, Zhang L. Comparison of respiratory pathogens in children with community-acquired pneumonia before and during the COVID-19 pandemic. BMC Pediatr 2023; 23:535. [PMID: 37891511 PMCID: PMC10605329 DOI: 10.1186/s12887-023-04246-0] [Citation(s) in RCA: 2] [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: 03/18/2023] [Accepted: 08/11/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Multifaceted non-pharmaceutical interventions during the COVID-19 pandemic have not only reduced the transmission of SARS-CoV2, but have had an effect on the prevalence of other pathogens. This retrospective study aimed to compare and analyze the changes of respiratory pathogens in hospitalized children with community-acquired pneumonia. METHODS From January 2019 to December 2020, children with community-acquired pneumonia were selected from the Department of Respiratory Medicine, Shanghai Children's Medical Center. On the first day of hospitalization, sputum, throat swabs, venous blood samples from them were collected for detection of pathogens. RESULTS A total of 2596 children with community-acquired pneumonia were enrolled, including 1871 patients in 2019 and 725 in 2020. The detection rate in 2020 was lower than in 2019, whether single or multiple pathogens. Compared with 2019, the detection rate of virus, especially parainfluenza virus, influenza virus and respiratory syncytial virus, all decreased in 2020. On the contrary, the prevalence of human rhinovirus was much higher than that in 2019. In addition, the positivity rate for bacteria did not change much over the two years, which seemed to be less affected by COVID-19. And Mycoplasma pneumoniae which broke out in 2019 has been in low prevalence since March 2020 even following the reopening of school. CONCLUSIONS Strict public health interventions for COVID-19 in China have effectively suppressed the spread of not only SARS-CoV2 but parainfluenza virus, influenza virus and Mycoplasma pneumonia as well. However, it had a much more limited effect on bacteria and rhinovirus. Therefore, more epidemiological surveillance of respiratory pathogens will help improve early preventive measures.
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Affiliation(s)
- Mingyu Tang
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Rd, Shanghai, 200127, China
| | - Wenfang Dong
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Rd, Shanghai, 200127, China
| | - Shuhua Yuan
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Rd, Shanghai, 200127, China
| | - Jiande Chen
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Rd, Shanghai, 200127, China
| | - Jie Lin
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Rd, Shanghai, 200127, China
| | - Jinhong Wu
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Rd, Shanghai, 200127, China
| | - Jing Zhang
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Rd, Shanghai, 200127, China
| | - Yong Yin
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Rd, Shanghai, 200127, China.
| | - Lei Zhang
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Rd, Shanghai, 200127, China.
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Touchton M, Knaul FM, Arreola-Ornelas H, Porteny T, Carniado ÓM, Faganello M, Hummel C, Otero S, Insua J, Patino F, Undurraga E, Pérez-Cruz P, Sanchez-Talanquer M, Velasco Guachalla VX, Nelson-Nuñez J, Boulding C, Calderon-Anyosa R, Garcia PJ, Vargas Enciso V. Non-pharmaceutical interventions to combat COVID-19 in the Americas described through daily sub-national data. Sci Data 2023; 10:734. [PMID: 37865630 PMCID: PMC10590388 DOI: 10.1038/s41597-023-02638-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 10/12/2023] [Indexed: 10/23/2023] Open
Abstract
This dataset covers national and subnational non-pharmaceutical interventions (NPI) to combat the COVID-19 pandemic in the Americas. Prior to the development of a vaccine, NPI were governments' primary tools to mitigate the spread of COVID-19. Variation in subnational responses to COVID-19 is high and is salient for health outcomes. This dataset captures governments' dynamic, varied NPI to combat COVID-19 for 80% of Latin America's population from each country's first case through December 2021. These daily data encompass all national and subnational units in Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Mexico, and Peru. The dataset includes individual and aggregate indices of nine NPI: school closures, work suspensions, public event cancellations, public transport suspensions, information campaigns, local travel restrictions, international travel controls, stay-at-home orders, and restrictions on the size of gatherings. We also collected data on mask mandates as a separate indicator. Local country-teams drew from multiple data sources, resulting in high-quality, reliable data. The dataset thus allows for consistent, meaningful comparisons of NPI within and across countries during the pandemic.
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Affiliation(s)
- Michael Touchton
- Department of Political Science, School of Arts and Sciences, University of Miami, Miami, Florida, USA
- Institute for Advanced Study of the Americas, University of Miami, Miami, Florida, USA
| | - Felicia Marie Knaul
- Institute for Advanced Study of the Americas, University of Miami, Miami, Florida, USA
- Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
- Tómatelo a Pecho, A.C., Mexico City, Mexico
- Fundación Mexicana para la Salud, A.C., Mexico City, Mexico
| | - Héctor Arreola-Ornelas
- Institute for Advanced Study of the Americas, University of Miami, Miami, Florida, USA.
- Tómatelo a Pecho, A.C., Mexico City, Mexico.
- Fundación Mexicana para la Salud, A.C., Mexico City, Mexico.
- Institute for Obesity Research, Tecnológico de Monterrey, Monterrey, Mexico.
- School of Government and Public Transformation, Tecnológico de Monterrey, Mexico City, Mexico.
| | - Thalia Porteny
- Institute for Advanced Study of the Americas, University of Miami, Miami, Florida, USA
- Department of Health Policy and Management, Columbia Mailman School of Public Health, New York, New York, USA
| | - Óscar Méndez Carniado
- Institute for Advanced Study of the Americas, University of Miami, Miami, Florida, USA
- Tómatelo a Pecho, A.C., Mexico City, Mexico
- Institute for Obesity Research, Tecnológico de Monterrey, Monterrey, Mexico
| | - Marco Faganello
- MAF dataScience, Universidade Estadual de Campinas, Campinas, Brazil
| | - Calla Hummel
- Department of Political Science, School of Arts and Sciences, University of Miami, Miami, Florida, USA
| | - Silvia Otero
- Facultad de Estudios Internacionales, Políticos y Urbanos, Universidad del Rosario, Bogotá, Colombia
| | - Jorge Insua
- Health Policy and Management, School of Biomedical Sciences, School of Government, School of Health Care Management, Universidad Austral, Buenos Aires, Argentina
- School of Public Health, University of Buenos Aires, Buenos Aires, Argentina
| | | | - Eduardo Undurraga
- Escuela de Gobierno, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Pedro Pérez-Cruz
- Departamento Medicina Interna, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millennium Nucleus for the Study of the Life Course and Vulnerability, Santiago, Chile
| | | | | | - Jami Nelson-Nuñez
- Department of Political Science, University of New Mexico, Albuquerque, New Mexico, USA
| | - Carew Boulding
- Department of Political Science, University of Colorado, Boulder, Colorado, USA
| | - Renzo Calderon-Anyosa
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Patricia J Garcia
- Universidad Peruana Cayetano Heredia, Lima, San Martin de Porres, Peru
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Zheng X, Zhao K, Xu X, Deng Y, Leung K, Wu JT, Leung GM, Peiris M, Poon LLM, Zhang T. Development and application of influenza virus wastewater surveillance in Hong Kong. WATER RESEARCH 2023; 245:120594. [PMID: 37741039 DOI: 10.1016/j.watres.2023.120594] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/03/2023] [Accepted: 09/06/2023] [Indexed: 09/25/2023]
Abstract
Wastewater surveillance is considered as a powerful tool in providing cost-effective, population-wide and near real-time surveillance results for controlling infectious diseases (i.e., SARS-CoV-2, influenza virus), complementary to clinical surveillance. To facilitate the utility of this emerging tool, we developed two preanalytical protocols (supernatant-based and pellet-based) for influenza A/B virus (IAV/IBV) wastewater surveillance and applied them to the established wastewater surveillance network for large-scale longitudinal monitoring in Hong Kong. We tested 724 wastewater samples from 24 stationary sites for weekly surveillance for 8 months and 458 wastewater samples from 11 wastewater treatment plants (WWTPs) for more frequent (three times per week) city-wide surveillance for 4 months when influenza season commenced. We found the city-wide IAV virus concentration in wastewater were associated with the detection rate and influenza-like illness plus rates (ILI+) of clinical respiratory specimens and increased significantly after the cancelling of mask mandate that was in place for COVID-19. IBV was at low detection rates and low virus concentration levels, consistent with the low detection rates observed by clinical surveillance. In addition, we conducted virus subtype identification in selected wastewater samples, and observed the H1pdm was the major circulation subtype. Moreover, the obtained virus signals were confirmed by Sanger sequencing of PCR products, suggesting the feasibility and applicability of established methods for rapid detection of influenza virus types and subtypes in wastewater surveillance. This study demonstrates the applicability of IAV/IBV wastewater surveillance to current wastewater infrastructures and it could be used as a rapid and cost-effective surveillance strategy to track virus transmission patterns in the community for timely public health actions in the future.
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Affiliation(s)
- Xiawan Zheng
- Environmental Microbiome Engineering and Biotechnology Lab, Center for Environmental Engineering Research, Department of Civil Engineering, The University of Hong Kong, Pokfulam Road, Hong Kong SAR, China
| | - Keyue Zhao
- Environmental Microbiome Engineering and Biotechnology Lab, Center for Environmental Engineering Research, Department of Civil Engineering, The University of Hong Kong, Pokfulam Road, Hong Kong SAR, China
| | - Xiaoqing Xu
- Environmental Microbiome Engineering and Biotechnology Lab, Center for Environmental Engineering Research, Department of Civil Engineering, The University of Hong Kong, Pokfulam Road, Hong Kong SAR, China
| | - Yu Deng
- Environmental Microbiome Engineering and Biotechnology Lab, Center for Environmental Engineering Research, Department of Civil Engineering, The University of Hong Kong, Pokfulam Road, Hong Kong SAR, China
| | - Kathy Leung
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Sassoon Road, Hong Kong SAR, China; Laboratory of Data Discovery for Health Limited (D(2)4H), Hong Kong Science Park, Hong Kong SAR, China; The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| | - Joseph T Wu
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Sassoon Road, Hong Kong SAR, China; Laboratory of Data Discovery for Health Limited (D(2)4H), Hong Kong Science Park, Hong Kong SAR, China; The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| | - Gabriel M Leung
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Sassoon Road, Hong Kong SAR, China; Laboratory of Data Discovery for Health Limited (D(2)4H), Hong Kong Science Park, Hong Kong SAR, China
| | - Malik Peiris
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Sassoon Road, Hong Kong SAR, China; HKU-Pasteur Research Pole, The University of Hong Kong, Sassoon Road, Hong Kong SAR, China
| | - Leo L M Poon
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Sassoon Road, Hong Kong SAR, China; HKU-Pasteur Research Pole, The University of Hong Kong, Sassoon Road, Hong Kong SAR, China
| | - Tong Zhang
- Environmental Microbiome Engineering and Biotechnology Lab, Center for Environmental Engineering Research, Department of Civil Engineering, The University of Hong Kong, Pokfulam Road, Hong Kong SAR, China; School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Sassoon Road, Hong Kong SAR, China; Macau Institute for Applied Research in Medicine and Health, Macau University of Science and Technology, Macau SAR, China.
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Licht A, Wetzker W, Scholz J, Scherag A, Weis S, Pletz MW, Bauer M, Dickmann P. Public health risk communication through the lens of a quarantined community: Insights from a coronavirus hotspot in Germany. PLoS One 2023; 18:e0292248. [PMID: 37824455 PMCID: PMC10569635 DOI: 10.1371/journal.pone.0292248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 09/17/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Quarantine is one of the most effective interventions to contain an infectious disease outbreak, yet it is one of the most disruptive. We investigated the quarantine of an entire village to better understand risk communication requirements for groups. METHODS We conducted a cross-sectional, mixed-methods survey study on a single cohort of adult residents in Neustadt am Rennsteig, Germany, six weeks after the removal of a 14-day mandatory community quarantine. The survey response rate was 33% (289/883 residents). FINDINGS Survey participants reported a lack of information on the quarantine implementation process. What authorities communicated was not necessarily what residents desired to know. While inhabitants used social media and telephones to communicate with each other, the official information sources were regional radio, television, newspapers and official websites. Public health authorities did not employ social media communication to engage with their communities. Despite a lack of information, the majority of respondents stated that they had complied with the quarantine and they expressed little sympathy for those who violated the quarantine. After lifting the quarantine, many respondents continued to avoid places where they suspected a significant risk of infection, such as family and friends' homes, doctor's offices and grocery stores. INTERPRETATION The survey participants utilised existing social networks to disseminate vital information and stabilise its group identity and behaviour (quarantine compliance). The authorities communicated sparsely in a unidirectional, top-down manner, without engaging the community. Despite the lack of official information, the social coherency of the group contributed to considerate and compliant conduct, but participants expressed dissatisfaction with official leadership and asked for more attention. CONCLUSION Public health risk communication must engage with communities more effectively. This necessitates a deeper comprehension of groups, their modes of communication and their social needs.
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Affiliation(s)
- Annika Licht
- Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - Wibke Wetzker
- Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - Juliane Scholz
- Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - André Scherag
- Institute of Medical Statistics, Computer and Data Sciences, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - Sebastian Weis
- Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Friedrich Schiller University, Jena, Germany
- Institute for Infectious Diseases and Infection Control, Jena University Hospital, Friedrich Schiller University, Jena, Germany
- Leibniz Institute for Infection Biology and Natural Product Research, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knoell Institute, Jena, Germany
| | - Mathias W. Pletz
- Institute for Infectious Diseases and Infection Control, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - Michael Bauer
- Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - Petra Dickmann
- Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Friedrich Schiller University, Jena, Germany
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Grépin KA, Aston J, Burns J. Effectiveness of international border control measures during the COVID-19 pandemic: a narrative synthesis of published systematic reviews. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2023; 381:20230134. [PMID: 37611627 PMCID: PMC10446907 DOI: 10.1098/rsta.2023.0134] [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: 04/30/2023] [Accepted: 05/23/2023] [Indexed: 08/25/2023]
Abstract
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'.
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Affiliation(s)
- Karen Ann Grépin
- School of Public Health, University of Hong Kong Faculty of Medicine, Pokfulam, Hong Kong
| | - John Aston
- Statistical Laboratory, University of Cambridge, Cambridge, CB3 0WB, UK
| | - Jacob Burns
- Ludwig-Maximilians University, Munich, 81377, Germany
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42
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Murphy C, Lim WW, Mills C, Wong JY, Chen D, Xie Y, Li M, Gould S, Xin H, Cheung JK, Bhatt S, Cowling BJ, Donnelly CA. Effectiveness of social distancing measures and lockdowns for reducing transmission of COVID-19 in non-healthcare, community-based settings. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2023; 381:20230132. [PMID: 37611629 PMCID: PMC10446910 DOI: 10.1098/rsta.2023.0132] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 05/23/2023] [Indexed: 08/25/2023]
Abstract
Social distancing measures (SDMs) are community-level interventions that aim to reduce person-to-person contacts in the community. SDMs were a major part of the responses first to contain, then to mitigate, the spread of SARS-CoV-2 in the community. Common SDMs included limiting the size of gatherings, closing schools and/or workplaces, implementing work-from-home arrangements, or more stringent restrictions such as lockdowns. This systematic review summarized the evidence for the effectiveness of nine SDMs. Almost all of the studies included were observational in nature, which meant that there were intrinsic risks of bias that could have been avoided were conditions randomly assigned to study participants. There were no instances where only one form of SDM had been in place in a particular setting during the study period, making it challenging to estimate the separate effect of each intervention. The more stringent SDMs such as stay-at-home orders, restrictions on mass gatherings and closures were estimated to be most effective at reducing SARS-CoV-2 transmission. Most studies included in this review suggested that combinations of SDMs successfully slowed or even stopped SARS-CoV-2 transmission in the community. However, individual effects and optimal combinations of interventions, as well as the optimal timing for particular measures, require further investigation. This article is part of the theme issue 'The effectiveness of non-pharmaceutical interventions on the COVID-19 pandemic: the evidence'.
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Affiliation(s)
- Caitriona Murphy
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Wey Wen Lim
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Cathal Mills
- Department of Statistics, University of Oxford, Oxford, UK
| | - Jessica Y. Wong
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Dongxuan Chen
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
- Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, New Territories, Hong Kong, People's Republic of China
| | - Yanmy Xie
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Mingwei Li
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
- Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, New Territories, Hong Kong, People's Republic of China
| | - Susan Gould
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Tropical and Infectious Disease Unit, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Hualei Xin
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Justin K. Cheung
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Samir Bhatt
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Kobenhavn, Denmark
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, UK
| | - Benjamin J. Cowling
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
- Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, New Territories, Hong Kong, People's Republic of China
| | - Christl A. Donnelly
- Department of Statistics, University of Oxford, Oxford, UK
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, UK
- Pandemic Sciences Institute, University of Oxford, Oxford, UK
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Alishaq M, Al Ajmi JA, Shaheen M, Elgendy M, Vinoy S, Thomas AG, Joseph S, Mathew TE, Joseph R, Thomas C, Alex AK, Thomas B, Nafady A, Elgendy H, Nafady-Hego H. SARS-CoV-2 infection in 3,241 School working staffs: Impact of SARS CoV-2 variants of concern [Wild, B.1.1.7 and Omicron]. PLoS One 2023; 18:e0291989. [PMID: 37792687 PMCID: PMC10550119 DOI: 10.1371/journal.pone.0291989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 09/05/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND There is debate over whether physical attendance at school affects the spread of the SARS-CoV-2 pandemic. METHODS A cohort of personnel from several schools in Qatar provided nasopharyngeal swabs (NPS) for SARS-CoV-2 RT-PCR and rapid antigen testing. Each of them was monitored for infection until February 2022. RESULTS In total, 3,241 employees gave samples for analysis. Prior to the start of the 2020-2021 academic year (Group I), 3.49% of samples tested positive for SARS-CoV-2. Most of the positive PCR results were from male, senior, non-teaching staff members. Only 110 (3.39%) employees who had enrolled in face-to-face instruction before the B.1.1.7 variant's emergence (Group II), 238 (7.34%) after the B.1.1.7 variant's emergence (Group III), and 410 (12.65%) after the introduction of the Omicron variant (Group IV) had reported infection by PCR test. Most people who tested positive by PCR after enrolling in school were young, female teachers. In the Cox Proportional-Hazards Model, exposure to a confirmed case, the presence of symptoms in the two weeks prior to exposure in all groups-young age in Groups II and III, male gender in Groups I and IV, shared housing in Group III, and the presence of comorbidities in Groups II and III independently predicted SARS-CoV-2 infection in school staff. CONCLUSION Critical information about the risk of SARS-CoV-2 infection in school workers during the whole pandemic is provided by our study. School operations in Qatar were made safer through initial and ongoing screenings, as well as widespread vaccination of school personnel.
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Affiliation(s)
- Moza Alishaq
- Corporate Quality Department, Hamad Medical Corporation, Doha, Qatar
| | | | - Mohammed Shaheen
- Corporate Quality Department, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed Elgendy
- Faculty of Medicine, Universiti Sains of Malaysia, Kelantan, Malaysia
| | - Suni Vinoy
- Corporate Quality Department, Hamad Medical Corporation, Doha, Qatar
| | | | - Sam Joseph
- Corporate Quality Department, Hamad Medical Corporation, Doha, Qatar
| | | | - Renjith Joseph
- Corporate Quality Department, Hamad Medical Corporation, Doha, Qatar
| | - Christymol Thomas
- Corporate Quality Department, Hamad Medical Corporation, Doha, Qatar
| | - Anju K. Alex
- Corporate Quality Department, Hamad Medical Corporation, Doha, Qatar
| | - Bincy Thomas
- Corporate Quality Department, Hamad Medical Corporation, Doha, Qatar
| | - Asmaa Nafady
- Faculty of Medicine, Clinical and Chemical Pathology Department, South Valley University, Qena, Egypt
| | - Hamed Elgendy
- Anesthesia Department, Hamad Medical Corporation, Doha, Qatar
- Anesthesia Department, Weill Cornell Medical College, Doha, Qatar
- Faculty of Medicine, Anesthesia Department, Qatar University, Doha, Qatar
| | - Hanaa Nafady-Hego
- Corporate Quality Department, Hamad Medical Corporation, Doha, Qatar
- Faculty of Medicine, Microbiology and Immunology Department, Assiut University, Assiut, Egypt
- Al Tahrir Medical Center, Doha, Qatar
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Chen SX, Ye FTF, Cheng KL, Ng JCK, Lam BCP, Hui BPH, Au AKY, Wu WCH, Gu D, Zeng Y. Social media trust predicts lower COVID-19 vaccination rates and higher excess mortality over 2 years. PNAS NEXUS 2023; 2:pgad318. [PMID: 37841324 PMCID: PMC10568527 DOI: 10.1093/pnasnexus/pgad318] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 09/13/2023] [Indexed: 10/17/2023]
Abstract
Trust plays a crucial role in implementing public health interventions against the COVID-19 pandemic. We examined the prospective associations of interpersonal, institutional, and media trust with vaccination rates and excess mortality over time in two multinational studies. In study 1, we investigated the country-level relationships between interpersonal trust, vaccination rates, and excess mortality across 54 countries. Interpersonal trust at the country level was calculated by aggregating data of 80,317 participants from the World Values Survey in 2017-20. Data on vaccination rates and excess mortality were obtained from the World Health Organization. Our findings indicated that higher levels of interpersonal trust were linked to higher vaccination rates and lower excess mortality rates in both 2020 and 2021. In study 2, we collected data from 18,171 adults in 35 countries/societies, stratified by age, gender, and region of residence. At the country/society level, interpersonal trust and trust in local healthcare facilities, local healthcare services, and healthcare professionals were associated with higher vaccination rates and lower excess mortality, whereas social media trust was associated with lower vaccination rates and higher excess mortality across three time points over 2 years. Our findings are robust when controlling for country-level covariates of the government stringency index, population density, and medical resources (i.e. critical care beds) in both studies.
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Affiliation(s)
- Sylvia Xiaohua Chen
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Frank Tian-fang Ye
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Kai Lam Cheng
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jacky C K Ng
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ben C P Lam
- Department of Psychology, Counselling and Therapy, La Trobe University, Melbourne, Australia
| | - Bryant P H Hui
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Algae K Y Au
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Wesley C H Wu
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Danan Gu
- Independent Researcher, New York, USA
| | - Yi Zeng
- National School of Development, Peking University, Beijing, China
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45
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Liang W, Lv H, Chen C, Sun Y, Hui DS, Mok CKP. Lack of neutralizing antibodies against influenza A viruses in adults during the 2022/2023 winter season - a serological study using retrospective samples collected in Hong Kong. Int J Infect Dis 2023; 135:1-4. [PMID: 37481108 DOI: 10.1016/j.ijid.2023.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 07/24/2023] Open
Abstract
OBJECTIVES Since the onset of the COVID-19 pandemic in 2020, there has been a significant decline in seasonal influenza infection cases in Hong Kong. However, this decline has also resulted in reduced opportunities for the development of influenza-specific antibodies in the community. The levels of antibodies required for protection against recently circulating influenza A viruses in the post-COVID-19 era remain unclear. METHODS This study involved the analysis of paired plasma samples collected from 479 healthy adults in Hong Kong in 2021 and 2022. The neutralizing titers of plasma against influenza A (H1N1) and (H3N2) viruses circulating before and after the COVID-19 outbreak were determined using a microneutralization assay. RESULTS The H1N1 and H3N2 vaccine strains selected for the 2022/23 season were found to be closely related to the recently circulating viruses. However, in the samples collected in 2022, only 14.61% and 0.42% showed a neutralization titer (MN50) ≥1:20 against H1N1 A/Wisconsin/588/2019 (H1/Wis19) and H3N2 A/Darwin/6/2021 (H3/Dar21), respectively. Notably, participants who reported receiving annual flu vaccinations exhibited a higher seropositive rate for H1/Wis19 compared to those who had never received the flu vaccine (28.06% vs. 5.30%). CONCLUSION Our results indicate that adults in Hong Kong generally lack neutralizing antibodies against circulating influenza A viruses, particularly H3N2. These findings underscore the importance of promoting flu vaccination in the post-COVID-19 era.
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Affiliation(s)
- Weiwen Liang
- HKU-Pasteur Research Pole, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Regions, China
| | - Huibin Lv
- Department of Biochemistry, University of Illinois at Urbana-Champaign, Urbana, USA
| | - Chunke Chen
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Regions, China; Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Regions, China
| | - Yuanxin Sun
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Regions, China; Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Regions, China
| | - David S Hui
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Regions, China; Stanley Ho Centre for Emerging Infectious Diseases, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Regions, China
| | - Chris Ka Pun Mok
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Regions, China; Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Regions, China.
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46
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Xu X, Liu X, Li J, Deng X, Dai T, Ji Q, Xiong D, Xie H. Environmental Risk Factors, Protective Factors, and Biomarkers for Allergic Rhinitis: A Systematic Umbrella Review of the Evidence. Clin Rev Allergy Immunol 2023; 65:188-205. [PMID: 37490237 PMCID: PMC10567804 DOI: 10.1007/s12016-023-08964-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2023] [Indexed: 07/26/2023]
Abstract
Many potential environmental risk factors, protective factors, and biomarkers of AR have been published, but so far, the strength and consistency of their evidence are unclear. We conducted a comprehensive review of environmental risk, protective factors, and biomarkers for AR to establish the evidence hierarchy. We systematically searched Embase, PubMed, Cochrane Library, and Web of Science electronic database from inception to December 31, 2022. We calculated summary effect estimate (odds ratio (OR), relative risk (RR), hazard ratio (HR), and standardized mean difference (SMD)), 95% confidence interval, random effects p value, I2 statistic, 95% prediction interval, small study effects, and excess significance biases, and stratification of the level of evidence. Methodological quality was assessed by AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews 2). We retrieved 4478 articles, of which 43 met the inclusion criteria. The 43 eligible articles identified 31 potential environmental risk factors (10,806,206 total population, two study not reported), 11 potential environmental protective factors (823,883 total population), and 34 potential biomarkers (158,716 total population) for meta-analyses. The credibility of evidence was convincing (class I) for tic disorders (OR = 2.89, 95% CI 2.11-3.95); and highly suggestive (class II) for early-life antibiotic use (OR = 3.73, 95% CI 3.06-4.55), exposure to indoor dampness (OR = 1.49, 95% CI 1.27-1.75), acetaminophen exposure (OR = 1.54, 95% CI 1.41-1.69), childhood acid suppressant use (OR = 1.40, 95% CI 1.23-1.59), exposure to indoor mold (OR = 1.66, 95% CI 1.26-2.18), coronavirus disease 2019 (OR = 0.11, 95% CI 0.06-0.22), and prolonged breastfeeding (OR = 0.72, 95% CI 0.65-0.79). This study is registered in PROSPERO (CRD42022384320).
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Affiliation(s)
- Xianpeng Xu
- Department of Otorhinolaryngology, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
- Department of Otorhinolaryngology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Xinghong Liu
- Department of Otorhinolaryngology, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
- Department of Otorhinolaryngology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Jiongke Li
- Department of Otorhinolaryngology, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
- Department of Otorhinolaryngology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Xinxing Deng
- Department of Otorhinolaryngology, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
- Department of Otorhinolaryngology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Tianrong Dai
- Department of Otorhinolaryngology, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
- Department of Otorhinolaryngology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Qingjie Ji
- Department of Dermatology, Quzhou hospital of Traditional Chinese Medicine, 324000, Quzhou, China
| | - Dajing Xiong
- Department of Otorhinolaryngology, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
- Department of Otorhinolaryngology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Hui Xie
- Department of Otorhinolaryngology, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China.
- Department of Otorhinolaryngology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China.
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Al-Zubaidy N, Fernandez Crespo R, Jones S, Gould L, Leis M, Maheswaran H, Neves AL, Darzi A, Drikvandi R. Exploring the relationship between government stringency and preventative social behaviours during the COVID-19 pandemic in the United Kingdom. Health Informatics J 2023; 29:14604582231215867. [PMID: 37982397 DOI: 10.1177/14604582231215867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
We constructed a preventive social behaviours (PSB) Index using survey questions that were aligned with WHO recommendations, and used linear regression to assess the impact of reported COVID-19 deaths (RCD), people's confidence of government handling of the pandemic (CGH) and government stringency (GS) in the United Kingdom (UK) over time on the PSB index. We used repeated, nationally representative, cross-sectional surveys in the UK over the course of 41 weeks from 1st April 2020 to January 28th, 2021, including a total of 38,092 participants. The PSB index was positively correlated with the logarithm of RCD (R: 0.881, p < .001), CGH (R: 0.592, p < .001) and GS (R: 0.785, p < .001), but was not correlated with time (R: -0.118, p = .485). A multivariate linear regression analysis suggests that the log of RCD (coefficient: 0.125, p < .001), GS (coefficient: 0.010, p = .019), and CGH (coefficient: 0.0.009, p < .001) had a positive and significant impact on the PSB Index, while time did not affect it significantly. These findings suggest that people's behaviours could have been affected by multiple factors during the pandemic, with the number of COVID-19 deaths being the largest contributor towards an increase in protective behaviours in our model.
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Affiliation(s)
- Noor Al-Zubaidy
- Institute of Global Health Innovation, Imperial College London, London, UK
| | | | - Sarah Jones
- Institute of Global Health Innovation, Imperial College London, London, UK
| | - Lisa Gould
- Institute of Global Health Innovation, Imperial College London, London, UK
| | - Melanie Leis
- Institute of Global Health Innovation, Imperial College London, London, UK
| | | | - Ana Luisa Neves
- Institute of Global Health Innovation, Imperial College London, London, UK
| | - Ara Darzi
- Institute of Global Health Innovation, Imperial College London, London, UK
| | - Reza Drikvandi
- Department of Mathematical Sciences, Durham University, Durham, UK
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48
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He M, Tang B, Xiao Y, Tang S. Transmission dynamics informed neural network with application to COVID-19 infections. Comput Biol Med 2023; 165:107431. [PMID: 37696183 DOI: 10.1016/j.compbiomed.2023.107431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/26/2023] [Accepted: 08/28/2023] [Indexed: 09/13/2023]
Abstract
Since the end of 2019 the COVID-19 repeatedly surges with most countries/territories experiencing multiple waves, and mechanism-based epidemic models played important roles in understanding the transmission mechanism of multiple epidemic waves. However, capturing temporal changes of the transmissibility of COVID-19 during the multiple waves keeps ill-posed problem for traditional mechanism-based epidemic compartment models, because that the transmission rate is usually assumed to be specific piecewise functions and more parameters are added to the model once multiple epidemic waves involved, which poses a huge challenge to parameter estimation. Meanwhile, data-driven deep neural networks fail to discover the driving factors of repeated outbreaks and lack interpretability. In this study, aiming at developing a data-driven method to project time-dependent parameters but also merging the advantage of mechanism-based models, we propose a transmission dynamics informed neural network (TDINN) by encoding the SEIRD compartment model into deep neural networks. We show that the proposed TDINN algorithm performs very well when fitting the COVID-19 epidemic data with multiple waves, where the epidemics in the United States, Italy, South Africa, and Kenya, and several outbreaks the Omicron variant in China are taken as examples. In addition, the numerical simulation shows that the trained TDINN can also perform as a predictive model to capture the future development of COVID-19 epidemic. We find that the transmission rate inferred by the TDINN frequently fluctuates, and a feedback loop between the epidemic shifting and the changes of transmissibility drives the occurrence of multiple waves. We observe a long response delay to the implementation of control interventions in the four countries, while the decline of the transmission rate in the outbreaks in China usually happens once the implementation of control interventions. The further simulation show that 17 days' delay of the response to the implementation of control interventions lead to a roughly four-fold increase in daily reported cases in one epidemic wave in Italy, which suggest that a rapid response to policies that strengthen control interventions can be effective in flattening the epidemic curve or avoiding subsequent epidemic waves. We observe that the transmission rate in the outbreaks in China is already decreasing before enhancing control interventions, providing the evidence that the increasing of the epidemics can drive self-conscious behavioural changes to protect against infections.
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Affiliation(s)
- Mengqi He
- School of Mathematics and Statistics, Shaanxi Normal University, Xi'an, China
| | - Biao Tang
- School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, China.
| | - Yanni Xiao
- School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, China
| | - Sanyi Tang
- School of Mathematics and Statistics, Shaanxi Normal University, Xi'an, China
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49
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Hanratty J, Keenan C, O'Connor SR, Leonard R, Chi Y, Ferguson J, Axiaq A, Miller S, Bradley D, Dempster M. Psychological and psychosocial determinants of COVID Health Related Behaviours (COHeRe): An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2023; 19:e1336. [PMID: 37361553 PMCID: PMC10286725 DOI: 10.1002/cl2.1336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
Background The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has resulted in illness, deaths and societal disruption on a global scale. Societies have implemented various control measures to reduce transmission of the virus and mitigate its impact. Individual behavioural changes are crucial to the successful implementation of these measures. Common recommended measures to limit risk of infection include frequent handwashing, reducing the frequency of social interactions and the use of face coverings. It is important to identify those factors that can predict the uptake and maintenance of these protective behaviours. Objectives We aimed to identify and map the existing evidence (published and unpublished) on psychological and psychosocial factors that determine uptake and adherence to behaviours aimed at reducing the risk of infection or transmission of COVID-19. Search Methods Our extensive search included electronic databases (n = 12), web searches, conference proceedings, government reports, other repositories including both published peer reviewed, pre-prints and grey literature. The search strategy was built around three concepts of interest including (1) context (terms relating to COVID-19), (2) behaviours of interest and (3) terms related to psychological and psychosocial determinants of COVID Health-Related Behaviours and adherence or compliance with recommended behaviours, to capture both malleable and non-malleable determinants (i.e. determinants that could be changed and those that could not). Selection Criteria This Evidence and Gap Map (EGM) includes all types of studies examining determinants of common recommended behaviours aimed at mitigating human-to-human spread of COVID-19. All potential malleable and non-malleable determinants of one or more behaviours are included in the map. As part of the mapping process, categories are used to group determinants. The mapping categories were based on a previous rapid review by Hanratty 2021. These include: 'behaviour', 'cognition', 'demographics', 'disease', 'emotions', 'health status', 'information', 'intervention', and 'knowledge'. Those not suitable for categorisation in any of these groups are included in the map as 'other' determinants. Data Collection and Analysis Results were imported to a bibliographic reference manager where duplications of identical studies gathered from multiple sources were removed. Data extraction procedures were managed in EPPI-Reviewer software. Information on study type, population, behaviours measured and determinants measured were extracted. We appraised the methodological quality of systematic reviews with AMSTAR-2. We did not appraise the quality of primary studies in this map. Main Results As of 1 June 2022 the EGM includes 1034 records reporting on 860 cross-sectional, 68 longitudinal, 78 qualitative, 25 reviews, 62 interventional, and 39 other studies (e.g., mixed-methods approaches). The map includes studies that measured social distancing (n = 487), masks and face coverings (n = 382), handwashing (n = 308), physical distancing (n = 177), isolation/quarantine (n = 157), respiratory hygiene/etiquette (n = 75), cleaning surfaces (n = 59), and avoiding touching the T-zone (n = 48). There were 333 studies that assessed composite measures of two or more behaviours. The largest cluster of determinants was 'demographics' (n = 730 studies), followed by 'cognition' (n = 496 studies) and determinants categorised as 'other' (n = 447). These included factors such as 'beliefs', 'culture' and 'access to resources'. Less evidence is available for some determinants such as 'interventions' (n = 99 studies), 'information' (n = 101 studies), and 'behaviour' (149 studies). Authors' Conclusions This EGM provides a valuable resource for researchers, policy-makers and the public to access the available evidence on the determinants of various COVID-19 health-related behaviours. The map can also be used to help guide research commissioning, by evidence synthesis teams and evidence intermediaries to inform policy during the ongoing pandemic and potential future outbreaks of COVID-19 or other respiratory infections. Evidence included in the map will be explored further through a series of systematic reviews examining the strength of the associations between malleable determinants and the uptake and maintenance of individual protective behaviours.
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Affiliation(s)
- Jennifer Hanratty
- School of PsychologyQueen's University BelfastBelfastUK
- Centre for Effective ServicesBelfastUK
| | | | | | | | - Yuan Chi
- Cochrane Global AgeingShanghaiChina
| | - Janet Ferguson
- School of PsychologyQueen's University BelfastBelfastUK
- Applied Behaviour Research ClinicUniversity of GalwayGalwayIreland
| | - Ariana Axiaq
- School of PsychologyQueen's University BelfastBelfastUK
| | - Sarah Miller
- School of Education, Social Sciences and Social WorkQueen's University BelfastBelfastUK
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AbiFaraj F, Lee D, Lacovara M, Kapoor T, Seshasai R, Bansal S, Greevy R, Guide A, Sharma S, Uribarri J, El Shamy O. Survey of Peritoneal Dialysis Patients' Challenges and Experiences during the COVID-19 Pandemic: A Multicenter Study in the United States. KIDNEY360 2023; 4:e1276-e1285. [PMID: 37357350 PMCID: PMC10547227 DOI: 10.34067/kid.0000000000000202] [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: 04/03/2023] [Accepted: 06/18/2023] [Indexed: 06/27/2023]
Abstract
Key Points The adjustments made by the dialysis units during the peak of the pandemic were effective in maneuvering the challenges faced by our patients during the COVID-19 pandemic. Patients who remained on PD were satisfied with the quality of care, felt supported by the unit staff, and did not report feeling anxious or depressed. Background During the coronavirus disease 2019 (COVID-19) pandemic, adjustments were made to peritoneal dialysis (PD) practices in the outpatient units. These were decisions made by dialysis providers, clinical staff, and governments with input from patient organizations in some instances. The patient perspective regarding these changes during the pandemic has not been explored. We sought to evaluate patient experiences and perceptions of the challenges they faced, institutional adjustments, and their mental health during the height of the COVID-19 pandemic in the United States. Methods We conducted a cross-sectional survey of PD patients across four home dialysis units affiliated with four large academic centers, who were on PD between March 2020 and March 2021. Results Ninety-eight participants completed the survey across the four outpatient PD clinics. Over 95% of patients did not have to change their home accommodations during the pandemic, and over 80% did not have issues getting their dialysis supplies and medications delivered. Ninety-three percent of patients felt comfortable coming to the dialysis unit if they needed to during the pandemic. Almost all patients (98%) felt supported by their dialysis staff during the peak of COVID-19 and had modified Patient Health Questionnaire 2 (91%) and Generalized Anxiety Disorder 2-item (96%) scores not consistent with depression or anxiety. Less than 10% of patients considered changing their dialysis modality. Conclusions The adjustments made by the dialysis units during the peak of the pandemic were effective in maneuvering the challenges faced by our patients during the COVID-19 pandemic. Overall, patients who remained on PD were satisfied with the quality of care, felt supported by the unit staff, and did not report feeling anxious or depressed.
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Affiliation(s)
- Farah AbiFaraj
- Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Dale Lee
- Division of Nephrology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Meghan Lacovara
- Renal Electrolyte and Hypertension Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Tarun Kapoor
- Department of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Rebecca Seshasai
- Renal Electrolyte and Hypertension Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Shweta Bansal
- Division of Nephrology, Department of Medicine, University of Texas Health San Antonio, San Antonio, Texas
| | - Robert Greevy
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Andrew Guide
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Shuchita Sharma
- Division of Nephrology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jaime Uribarri
- Division of Nephrology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Osama El Shamy
- Department of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, Tennessee
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