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Impact of the COVID-19 pandemic on outcomes of cholecystectomy for acute cholecystitis: a national cohort study. ANZ J Surg 2024; 94:674-683. [PMID: 38426369 DOI: 10.1111/ans.18830] [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: 10/14/2023] [Revised: 11/23/2023] [Accepted: 12/07/2023] [Indexed: 03/02/2024]
Abstract
BACKGROUND The COVID-19 pandemic was associated with significant disruptions to healthcare provision globally and in Aotearoa New Zealand. It remains unclear how this disruption affected the surgical management of acute cholecystitis and whether there are ongoing impacts. METHODS We conducted a secondary analysis of two multicentre cohort studies (CHOLECOVID and CHOLENZ) on patients who underwent cholecystectomy for acute cholecystitis. Participants were categorized into pre-pandemic (September-November 2019), pandemic (March-May 2020), and late-pandemic (August-October 2021) phases. Baseline demographics, clinical management, and 30-day postoperative complications were assessed between phases. Multivariable logistic regression was used to explore the impact of timing of operation on rates of hospital readmission and postoperative complications. RESULTS 517 participants were included, of whom 85 (16%) were in the pre-pandemic-phase, 52 (10%) were in the pandemic phase, and 380 (73%) were in the late-pandemic phase. Pandemic and late-pandemic phase participants were more comorbid and had higher rates of obesity and deranged blood results than pre-pandemic. After multivariable adjustment, there were no differences in rates of hospital readmission or postoperative complications at 30-day follow-up across phases. CONCLUSION The COVID-19 pandemic had minimal impacts on the provision of cholecystectomy for acute cholecystitis in Aotearoa New Zealand. However, patients managed during the COVID-19 pandemic were more comorbid and had higher rates of obesity and elevated inflammatory markers.
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Bayly H, Stoddard M, Van Egeren D, Murray EJ, Raifman J, Chakravarty A, White LF. Looking under the lamp-post: quantifying the performance of contact tracing in the United States during the SARS-CoV-2 pandemic. BMC Public Health 2024; 24:595. [PMID: 38395830 PMCID: PMC10893709 DOI: 10.1186/s12889-024-18012-z] [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: 05/18/2023] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
Contact tracing forms a crucial part of the public-health toolbox in mitigating and understanding emergent pathogens and nascent disease outbreaks. Contact tracing in the United States was conducted during the pre-Omicron phase of the ongoing COVID-19 pandemic. This tracing relied on voluntary reporting and responses, often using rapid antigen tests due to lack of accessibility to PCR tests. These limitations, combined with SARS-CoV-2's propensity for asymptomatic transmission, raise the question "how reliable was contact tracing for COVID-19 in the United States"? We answered this question using a Markov model to examine the efficiency with which transmission could be detected based on the design and response rates of contact tracing studies in the United States. Our results suggest that contact tracing protocols in the U.S. are unlikely to have identified more than 1.65% (95% uncertainty interval: 1.62-1.68%) of transmission events with PCR testing and 1.00% (95% uncertainty interval 0.98-1.02%) with rapid antigen testing. When considering a more robust contact tracing scenario, based on compliance rates in East Asia with PCR testing, this increases to 62.7% (95% uncertainty interval: 62.6-62.8%). We did not assume presence of asymptomatic transmission or superspreading, making our estimates upper bounds on the actual percentages traced. These findings highlight the limitations in interpretability for studies of SARS-CoV-2 disease spread based on U.S. contact tracing and underscore the vulnerability of the population to future disease outbreaks, for SARS-CoV-2 and other pathogens.
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Affiliation(s)
- Henry Bayly
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | | | | | - Eleanor J Murray
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Julia Raifman
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA
| | | | - Laura F White
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.
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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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Broadbent E, Nater U, Skoluda N, Gasteiger N, Jia R, Chalder T, Law M, Vedhara K. Changes in hair cortisol in a New Zealand community sample during the Covid-19 pandemic. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2024; 17:100228. [PMID: 38404507 PMCID: PMC10884750 DOI: 10.1016/j.cpnec.2024.100228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/31/2024] [Accepted: 02/02/2024] [Indexed: 02/27/2024] Open
Abstract
Background Evidence suggests that countries with higher Covid-19 infection rates experienced poorer mental health. This study examined whether hair cortisol reduced over time in New Zealand, a country that managed to eliminate the virus in the first year of the pandemic due to an initial strict lockdown. Methods A longitudinal cohort study assessed self-reported stress, anxiety and depression and collected hair samples that were analyzed for cortisol, across two waves in 2020. The sample consisted of 44 adults who each returned two 3 cm hair samples and completed self-reports. Hair cortisol was assessed per centimetre. Results Hair cortisol reduced over time (F (5, 99.126) = 10.15, p < .001, partial eta squared = 0.19), as did anxiety and depression. Higher hair cortisol was significantly associated with more negative life events reported at wave two (r = 0.30 segment 1, r = 0.34 segment 2, p < .05), but not anxiety or depression. Conclusions Strict virus control measures may not only reduce infection rates, but also reduce psychological distress, and hair cortisol over time.
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Affiliation(s)
- Elizabeth Broadbent
- Department of Psychological Medicine, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Urs Nater
- University Research Platform “The Stress of Life (SOLE) – Processes and Mechanisms Underlying Everyday Life Stress”, Department of Clinical and Health Psychology, University of Vienna, Liebiggasse 5, 1010, Vienna, Austria
| | - Nadine Skoluda
- University Research Platform “The Stress of Life (SOLE) – Processes and Mechanisms Underlying Everyday Life Stress”, Department of Clinical and Health Psychology, University of Vienna, Liebiggasse 5, 1010, Vienna, Austria
| | - Norina Gasteiger
- Department of Psychological Medicine, University of Auckland, Private Bag 92019, Auckland, New Zealand
- School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Ru Jia
- Centre for Academic Primary Care, School of Medicine, University of Nottingham, UK
| | - Trudie Chalder
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16, De Crespigny Park, London, SE5 8AF, UK
| | - Mikaela Law
- Department of Psychological Medicine, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Kavita Vedhara
- School of Psychology, Cardiff University, Tower Building, Cardiff, CF10 3AT, UK
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5
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Hsieh E, Dey D, Grainger R, Li M, Machado PM, Ugarte-Gil MF, Yazdany J. Global Perspective on the Impact of the COVID-19 Pandemic on Rheumatology and Health Equity. Arthritis Care Res (Hoboken) 2024; 76:22-31. [PMID: 37277949 DOI: 10.1002/acr.25169] [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: 05/05/2023] [Accepted: 05/30/2023] [Indexed: 06/07/2023]
Abstract
Although the public health emergency associated with the COVID-19 pandemic has ended, challenges remain, especially for individuals with rheumatic diseases. We aimed to assess the historical and ongoing effects of COVID-19 on individuals with rheumatic diseases and rheumatology practices globally, with specific attention to vulnerable communities and lessons learned. We reviewed literature from several countries and regions, including Africa, Australia and New Zealand, China, Europe, Latin America, and the US. In this review, we summarize literature that not only examines the impact of the pandemic on individuals with rheumatic diseases, but also research that reports the lasting changes to rheumatology patient care and practice, and health service use. Across countries, challenges faced by individuals with rheumatic diseases during the pandemic included disruptions in health care and medication supply shortages. These challenges were associated with worse disease and mental health outcomes in some studies, particularly among those who had social vulnerabilities defined by socioeconomic, race, or rurality. Moreover, rheumatology practice was impacted in all regions, with the uptake of telemedicine and changes in health care utilization. While many regions developed rapid guidelines to disseminate scientific information, misinformation and disinformation remained widespread. Finally, vaccine uptake among individuals with rheumatic diseases has been uneven across the world. As the acute phase of the pandemic wanes, ongoing efforts are needed to improve health care access, stabilize rheumatology drug supplies, improve public health communication, and implement evidence-based vaccination practices to reduce COVID-19 morbidity and mortality among individuals with rheumatic diseases.
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Affiliation(s)
- Evelyn Hsieh
- Yale School of Medicine, New Haven, Connecticut, and VA Connecticut Healthcare System, West Haven, Connecticut
| | - Dzifa Dey
- Korle-bu Teaching Hospital and the University of Ghana Medical School, Accra, Ghana
| | | | - Mengtao Li
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases, and Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Pedro M Machado
- University College London, NIHR University College London Hospitals Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, Northwick Park Hospital, and London North West University Healthcare NHS Trust, London, UK
| | - Manuel F Ugarte-Gil
- Universidad Científica del Sur and Hospital Nacional Guillermo Almenara Irigoyen - EsSalud, Lima, Perú
| | - Jinoos Yazdany
- San Francisco General Hospital and University of California, San Francisco
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6
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Bayly H, Mei W, Egeren D, Stoddard M, Chakravarty A, White LF. Accuracy of Inferences About the Reproductive Number and Superspreading Potential of SARS-CoV-2 with Incomplete Contact Tracing Data. RESEARCH SQUARE 2023:rs.3.rs-3760127. [PMID: 38234843 PMCID: PMC10793487 DOI: 10.21203/rs.3.rs-3760127/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
The basic reproductive number (R0) and superspreading potential ( k ) are key epidemiological parameters that inform our understanding of a disease's transmission. Often these values are estimated using the data obtained from contact tracing studies. Here we performed a simulation study to understand how incomplete data due to preferential contact tracing impacted the accuracy and inferences about the transmission of SARS-CoV-2. Our results indicate that as the number of positive contacts traced decreases, our estimates of R0 tend to decrease and our estimates of ktend to increase. Notably, when there are large amounts of positive contacts missed in the tracing process, we can conclude that there is no indication of superspreading even if we know there is. The results of this study highlight the need for a unified public health response to transmissible diseases.
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Affiliation(s)
| | - Winnie Mei
- University of Washington School of Public Health
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7
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Evans MV, Ramiadantsoa T, Kauffman K, Moody J, Nunn CL, Rabezara JY, Raharimalala P, Randriamoria TM, Soarimalala V, Titcomb G, Garchitorena A, Roche B. Sociodemographic Variables Can Guide Prioritized Testing Strategies for Epidemic Control in Resource-Limited Contexts. J Infect Dis 2023; 228:1189-1197. [PMID: 36961853 PMCID: PMC11007394 DOI: 10.1093/infdis/jiad076] [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: 12/13/2022] [Revised: 02/08/2023] [Accepted: 03/22/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Targeted surveillance allows public health authorities to implement testing and isolation strategies when diagnostic resources are limited, and can be implemented via the consideration of social network topologies. However, it remains unclear how to implement such surveillance and control when network data are unavailable. METHODS We evaluated the ability of sociodemographic proxies of degree centrality to guide prioritized testing of infected individuals compared to known degree centrality. Proxies were estimated via readily available sociodemographic variables (age, gender, marital status, educational attainment, household size). We simulated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemics via a susceptible-exposed-infected-recovered individual-based model on 2 contact networks from rural Madagascar to test applicability of these findings to low-resource contexts. RESULTS Targeted testing using sociodemographic proxies performed similarly to targeted testing using known degree centralities. At low testing capacity, using proxies reduced infection burden by 22%-33% while using 20% fewer tests, compared to random testing. By comparison, using known degree centrality reduced the infection burden by 31%-44% while using 26%-29% fewer tests. CONCLUSIONS We demonstrate that incorporating social network information into epidemic control strategies is an effective countermeasure to low testing capacity and can be implemented via sociodemographic proxies when social network data are unavailable.
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Affiliation(s)
- Michelle V Evans
- Maladies Infectieuses et Vecteurs : Écologie, Génétique, Évolution et Contrôle, Université Montpellier, CNRS, IRD, Montpellier, France
| | - Tanjona Ramiadantsoa
- Maladies Infectieuses et Vecteurs : Écologie, Génétique, Évolution et Contrôle, Université Montpellier, CNRS, IRD, Montpellier, France
| | - Kayla Kauffman
- Department of Evolutionary Anthropology, Duke University, Durham, North Carolina, USA
- Duke Global Health Institute, Durham, North Carolina, USA
- Ecology, Evolution, and Marine Biology, University of California, Santa Barbara, California, USA
| | - James Moody
- Department of Sociology, Duke University, Durham, North Carolina, USA
| | - Charles L Nunn
- Department of Evolutionary Anthropology, Duke University, Durham, North Carolina, USA
- Duke Global Health Institute, Durham, North Carolina, USA
| | - Jean Yves Rabezara
- Department of Science and Technology, University of Antsiranana, Antsiranana, Madagascar
| | | | - Toky M Randriamoria
- Association Vahatra, Antananarivo, Madagascar
- Zoologie et Biodiversité Animale, Domaine Sciences et Technologies, Université d’Antananarivo, Antananarivo, Madagascar
| | - Voahangy Soarimalala
- Association Vahatra, Antananarivo, Madagascar
- Institut des Sciences et Techniques de l’Environnement, Université de Fianarantsoa, Fianarantsoa, Madagascar
| | - Georgia Titcomb
- Ecology, Evolution, and Marine Biology, University of California, Santa Barbara, California, USA
- Marine Science Institute, University of California, Santa Barbara, California, USA
- Department of Fish, Wildlife, and Conservation Biology, Colorado State University, Fort Collins, Colorado, USA
| | - Andres Garchitorena
- Maladies Infectieuses et Vecteurs : Écologie, Génétique, Évolution et Contrôle, Université Montpellier, CNRS, IRD, Montpellier, France
- Pivot, Ifanadiana, Madagascar
| | - Benjamin Roche
- Maladies Infectieuses et Vecteurs : Écologie, Génétique, Évolution et Contrôle, Université Montpellier, CNRS, IRD, Montpellier, France
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8
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Naji O, Darwish I, Bessame K, Vaghela T, Hawkins A, Elsakka M, Merai H, Lowe J, Schechter M, Moses S, Busby A, Sullivan K, Wellsted D, Zamir MA, Kandil H. A Comparison of the Epidemiological Characteristics Between Influenza and COVID-19 Patients: A Retrospective, Observational Cohort Study. Cureus 2023; 15:e49280. [PMID: 38143669 PMCID: PMC10746956 DOI: 10.7759/cureus.49280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2023] [Indexed: 12/26/2023] Open
Abstract
Background and objective It is crucial to make early differentiation between coronavirus disease 2019 (COVID-19) and seasonal influenza infections at the time of a patient's presentation to the emergency department (ED). In light of this, this study aimed to identify key epidemiological, initial laboratory, and radiological differences that would enable early recognition during co-circulation. Methods This was a retrospective, observational cohort study. All adult patients presenting to our ED at the Watford General Hospital, UK, with a laboratory-confirmed diagnosis of COVID-19 (2019/20) or influenza (2018/19) infection were included in this study. Demographic, laboratory, and radiological data were collected. Binary logistic regression was employed to determine features associated with COVID-19 infection rather than influenza. Results Chest radiographs suggestive of viral pneumonitis and older age (≥80 years) were associated with increased odds of having COVID-19 [odds ratio (OR): 47.00, 95% confidence interval (CI): 21.63-102.13 and OR: 64.85, 95% CI: 19.96-210.69 respectively]. Low eosinophils (<0.02 x 109/L) were found to increase the odds of COVID-19 (OR: 2.12, 95% CI: 1.44-3.10, p<0.001). Conclusions Gaining awareness about the epidemiological, biological, and radiologic presentation of influenza-like illness can be useful for clinicians in ED to differentiate between COVID-19 and influenza. This study showed that older age, eosinopenia, and radiographic evidence of viral pneumonitis significantly increase the odds of having COVID-19 compared to influenza. Further research is needed to determine if these findings are affected by acquired or natural immunity.
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Affiliation(s)
- Omar Naji
- Orthopaedics, West Hertfordshire Hospitals NHS Trust, Watford, GBR
| | - Iman Darwish
- Internal Medicine, West Hertfordshire Hospitals NHS Trust, Watford, GBR
| | - Khaoula Bessame
- Radiology, West Hertfordshire Hospitals NHS Trust, Watford, GBR
| | - Tejal Vaghela
- Corporate Department, West Hertfordshire Hospitals NHS Trust, Watford, GBR
| | - Anja Hawkins
- Microbiology, West Hertfordshire Hospitals NHS Trust, Watford, GBR
| | - Mohamed Elsakka
- Radiology, West Hertfordshire Hospitals NHS Trust, Watford, GBR
| | - Hema Merai
- Radiology, West Hertfordshire Hospitals NHS Trust, Watford, GBR
| | - Jeremy Lowe
- Corporate Department, West Hertfordshire Hospitals NHS Trust, Watford, GBR
| | - Miriam Schechter
- Corporate Department, West Hertfordshire Hospitals NHS Trust, Watford, GBR
| | - Samuel Moses
- Virology, East Kent Hospitals University NHS Foundation, Kennington, GBR
| | - Amanda Busby
- Health Research Methods Unit, University of Hertfordshire, Hatfield, GBR
| | - Keith Sullivan
- Health Research Methods Unit, University of Hertfordshire, Hatfield, GBR
| | - David Wellsted
- Health Research Methods Unit, University of Hertfordshire, Hatfield, GBR
| | | | - Hala Kandil
- Microbiology, West Hertfordshire Hospitals NHS Trust, Watford, GBR
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9
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Chan AHY, Tomlin A, Chan E, Harrison J, Beyene KA. Effect of the COVID-19 pandemic on asthma exacerbations in New Zealand: An interrupted time series analysis. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2023; 2:100157. [PMID: 37781646 PMCID: PMC10509955 DOI: 10.1016/j.jacig.2023.100157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/22/2023] [Accepted: 04/07/2023] [Indexed: 10/03/2023]
Abstract
Background New Zealand (NZ) implemented some of the strictest restrictions during the novel coronavirus pandemic (coronavirus disease 2019 [COVID-19]), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). How this impacted asthma exacerbation rates in NZ is unknown. Objective We sought to explore the effects of the COVID-19 restrictions on asthma exacerbations in NZ during 2020. Methods We used a population-based, interrupted time series to examine the impact of the first COVID-19 lockdown in NZ on asthma exacerbation rate. The primary outcome measure was change in the monthly exacerbation rate, defined as hospitalization and/or course of corticosteroids, before and after the first lockdown. In a secondary analysis, we quantified the number of patients with asthma, the actual asthma exacerbation rate from March to December 2019 versus March to December 2020, and the number of asthma hospitalizations. Results There was a significant drop in the exacerbation rate immediately after lockdown (-3.02; P < .0001) followed by a significant and sustained increasing trend; the rate postlockdown increased relative to that prelockdown (0.27; P < .0001). Similar patterns were observed in all sociodemographic groups. In our secondary analysis, we identified 507,622 people with asthma; this reduced to 458,023 in 2020 postlockdown. The overall asthma exacerbation rate was 33.3% less in 2020 than in 2019 (reduction from 48.6/1000 patients to 32.4/1000 patients). The rate of asthma hospitalizations decreased from 9.5 per 1000 patients in 2019 to 6.2 per 1000 patients in 2020; this decrease was observed across all demographic groups. Conclusions The first COVID-19 lockdown in 2020 in NZ significantly reduced asthma exacerbation rates across all sociodemographic groups. Whether these reductions are sustained requires further investigation.
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Affiliation(s)
- Amy Hai Yan Chan
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Andrew Tomlin
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Eliza Chan
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Jeff Harrison
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Kebede A. Beyene
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- Department of Pharmaceutical and Administrative Sciences, St Louis College of Pharmacy, University of Health Sciences and Pharmacy, St Louis, Mo
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10
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Littlecott H, Herd C, O'Rourke J, Chaparro LT, Keeling M, James Rubin G, Fearon E. Effectiveness of testing, contact tracing and isolation interventions among the general population on reducing transmission of SARS-CoV-2: a systematic review. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2023; 381:20230131. [PMID: 37611628 PMCID: PMC10446909 DOI: 10.1098/rsta.2023.0131] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 05/23/2023] [Indexed: 08/25/2023]
Abstract
We conducted a systematic literature review of general population testing, contact tracing, case isolation and contact quarantine interventions to assess their effectiveness in reducing SARS-CoV-2 transmission, as implemented in real-world settings. We designed a broad search strategy and aimed to identify peer-reviewed studies of any design provided there was a quantitative measure of effectiveness on a transmission outcome. Studies that assessed the effect of testing or diagnosis on disease outcomes via treatment, but did not assess a transmission outcome, were not included. We focused on interventions implemented among the general population rather than in specific settings; these were from anywhere in the world and published any time after 1 January 2020 until the end of 2022. From 26 720 titles and abstracts, 1181 were reviewed as full text, and 25 met our inclusion criteria. These 25 studies included one randomized control trial (RCT) and the remaining 24 analysed empirical data and made some attempt to control for confounding. Studies included were categorized by the type of intervention: contact tracing (seven studies); specific testing strategies (12 studies); strategies for isolating cases/contacts (four studies); and 'test, trace, isolate' (TTI) as a part of a package of interventions (two studies). None of the 25 studies were rated at low risk of bias and many were rated as serious risk of bias, particularly due to the likely presence of uncontrolled confounding factors, which was a major challenge in assessing the independent effects of TTI in observational studies. These confounding factors are to be expected from observational studies during an on-going pandemic, when the emphasis was on reducing the epidemic burden rather than trial design. Findings from these 25 studies suggested an important public health role for testing followed by isolation, especially where mass and serial testing was used to reduce transmission. Some of the most compelling analyses came from examining fine-grained within-country data on contact tracing; while broader studies which compared behaviour between countries also often found TTI led to reduced transmission and mortality, this was not universal. There was limited evidence for the benefit of isolation of cases/contacts away from the home environment. One study, an RCT, showed that daily testing of contacts could be a viable strategy to replace lengthy quarantine of contacts. Based on the scarcity of robust empirical evidence, we were not able to draw any firm quantitative conclusions about the quantitative impact of TTI interventions in different epidemic contexts. While the majority of studies found that testing, tracing and isolation reduced transmission, evidence for the scale of this impact is only available for specific scenarios and hence is not necessarily generalizable. Our review therefore emphasizes the need to conduct robust experimental studies that help inform the likely quantitative impact of different TTI interventions on transmission and their optimal design. Work is needed to support such studies in the context of future emerging epidemics, along with assessments of the cost-effectiveness of TTI interventions, which was beyond the scope of this review but will be critical to decision-making. 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)
- Hannah Littlecott
- Institute for Medical Information Processing, Biometry and Epidemiology—IBE, Chair of Public Health and Health Services Research, LMU Munich, Germany
| | - Clare Herd
- Institute for Global Health, Faculty of Population Health Sciences, University College London, London, UK
| | - John O'Rourke
- Institute for Global Health, Faculty of Population Health Sciences, University College London, London, UK
| | - Lina Toncon Chaparro
- Institute for Global Health, Faculty of Population Health Sciences, University College London, London, UK
| | - Matt Keeling
- Zeeman Institute (SBIDER), Mathematics Institute and School of Life Sciences, University of Warwick, Coventry, UK
- JUNIPER consortium, UK
| | - G. James Rubin
- Department of Psychological Medicine, King's College London, London, UK
| | - Elizabeth Fearon
- Institute for Global Health, Faculty of Population Health Sciences, University College London, London, UK
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
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11
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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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12
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Frey R, Balmer D. Psychosocial well-being in Long-Term Care in the Wake of COVID-19: Findings from a Qualitative Study in New Zealand. J Cross Cult Gerontol 2023; 38:263-283. [PMID: 37466844 PMCID: PMC10447292 DOI: 10.1007/s10823-023-09485-3] [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: 07/15/2023] [Indexed: 07/20/2023]
Abstract
Drawing on Mason Durie's (1985) New Zealand Whare Tapa Whā model of health (spiritual, emotional, physical, and family domains), the goal was to link a model of well-being with the lived reality for long-term care residents and bereaved family members during COVID-19. Interviews were conducted with five residents and six family members of previous residents of one long-term care in one urban centre between July and September 2020. The increased demands imposed by the pandemic highlighted the gaps in well-being for residents and families. In particular, the inability to connect with family during COVID-19 restrictions reduced perceptions of well-being for residents. Study findings indicate that the provision of well-being for older adults and families in long-term care extends beyond the narrow bounds of the biomedical model. The Whare Tapa Whā model provides a valuable framework describing the holistic balance needed between the four health domains.
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Affiliation(s)
- Rosemary Frey
- School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Grafton, Auckland, New Zealand.
| | - Deborah Balmer
- School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Grafton, Auckland, New Zealand
- Western Australian Centre for Rural Health (WACRH), University of Western Australia, Geraldton, Australia
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13
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Hatter L, Eathorne A, Hills T, Bruce P, Houghton C, Weatherall M, Beasley R. Patterns of Asthma Medication Use in New Zealand After Publication of National Asthma Guidelines. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:2757-2764.e5. [PMID: 37178765 DOI: 10.1016/j.jaip.2023.04.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND In June 2020, the New Zealand (NZ) adolescent and adult asthma guidelines recommended budesonide/formoterol, taken as maintenance and/or reliever therapy, as the preferred therapeutic approach. OBJECTIVE To investigate whether these recommendations were associated with changes in clinical practice indicated by asthma medication use trends. METHODS NZ national dispensing data for inhaler medications from January 2010 to December 2021 were reviewed. Monthly "dispensings" of inhaled budesonide/formoterol, inhaled corticosteroid (ICS), other ICS/long-acting β2-agonists (LABA), and inhaled short-acting β2-agonists (SABA), for the 12+ age group, were displayed graphically with piecewise regression used to produce plots of rates by time with a July 1, 2020, break point. The number of dispensings in the last 6 months that data were available (July-December 2021) was compared with the corresponding period, July-December 2019. RESULTS Budesonide/formoterol dispensing increased markedly after July 1, 2020 (regression coefficient 41.1 inhalers dispensed/100,000 population per month [95% confidence interval (CI): 36.3-45.6, P < .0001]; 64.7% increase in the number of dispensings between July-December 2019 and July-December 2021), in contrast to "other ICS/LABA" (regression coefficient: -15.9 [95% CI: -22.2 to -9.6, P < .0001]; -1.7% decrease) and SABA (regression coefficient: -14.7 [95% CI: -29.7 to 0.3, P = .055]; -10.6% decrease), respectively. CONCLUSION In NZ, a progressive increase in budesonide/formoterol dispensing, accompanied by a reduction in SABA and "other ICS/LABA" dispensing, occurred after publication of the 2020 NZ asthma guidelines. While acknowledging the limitations in the interpretation of temporal associations, these findings suggest that the transition to ICS/formoterol reliever-based therapy can be achieved if recommended and promoted as the preferred therapeutic approach in national guidelines.
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Affiliation(s)
- Lee Hatter
- Medical Research Institute of New Zealand, Wellington, New Zealand; School of Biological Sciences, Victoria University of Wellington, Wellington, New Zealand
| | - Allie Eathorne
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Tom Hills
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Pepa Bruce
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Claire Houghton
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Mark Weatherall
- Department of Medicine, University of Otago Wellington, Wellington, New Zealand
| | - Richard Beasley
- Medical Research Institute of New Zealand, Wellington, New Zealand; School of Biological Sciences, Victoria University of Wellington, Wellington, New Zealand.
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14
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Kaur N, Stephens C. An Examination of Coping Strategies that Moderated the Effects of COVID-19-Related Stress on Anxiety Among Older Adults in Aotearoa/NZ. J Aging Health 2023:8982643231199141. [PMID: 37655482 DOI: 10.1177/08982643231199141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Objectives: 1. To describe perceived stress and changes in anxiety and coping among older adults between 2018 and 2020. 2. To examine the moderating roles of social support, exercise, alcohol use, and smoking on the relationship between perceived stress and anxiety. Methods: Longitudinal data collected from 3275 participants (M = 68.1 years) as part of the NZ Health, Work, and Retirement study's 2018 and 2020 biennial surveys, were analyzed using hierarchical regression. Results: Older adults perceived COVID-19 as a low-level source of stress. Social support and alcohol use moderated the relationship between perceived mental stress and anxiety. At high-stress levels, only social support exerted a protective effect against the negative impact of stress on anxiety. Discussion: These findings support the general resilience of many older adults and highlight the effectiveness of coping strategies used by those groups who are more likely to be vulnerable to mental stress during a pandemic.
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Affiliation(s)
- Navneet Kaur
- School of Psychology, Massey University, Palmerston North, New Zealand
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15
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Walton M, Pletzer V, Teunissen T, Lumley T, Hanlon T. Adverse Events Following the BNT162b2 mRNA COVID-19 Vaccine (Pfizer-BioNTech) in Aotearoa New Zealand. Drug Saf 2023; 46:867-879. [PMID: 37556109 PMCID: PMC10442303 DOI: 10.1007/s40264-023-01332-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2023] [Indexed: 08/10/2023]
Abstract
INTRODUCTION In February 2021, New Zealand began its largest ever immunisation programme with the BNT162b2 mRNA coronavirus disease 2019 (COVID-19) vaccine. OBJECTIVE We aimed to understand the association between 12 adverse events of special interest (AESIs) and a primary dose of BNT162b2 in the New Zealand population aged ≥5 years from 19 February 2021 through 10 February 2022. METHODS Using national electronic health records, the observed rates of AESIs within a risk period (1-21 days) following vaccination were compared with the expected rates based on background data (2014-2019). Standardised incidence ratios (SIRs) were estimated for each AESI with 95% confidence intervals (CIs) using age group-specific background rates. The risk difference was calculated to estimate the excess or reduced number of events per 100,000 persons vaccinated in the risk period. RESULTS As of 10 February 2022, 4,277,163 first doses and 4,114,364 second doses of BNT162b2 had been administered to the eligible New Zealand population aged ≥5 years. The SIRs for 11 of the 12 selected AESIs were not statistically significantly increased post vaccination. The SIR (95% CI) for myo/pericarditis following the first dose was 2.3 (1.8-2.7), with a risk difference (95% CI) of 1.3 (0.9-1.8), per 100,000 persons vaccinated, and 4.0 (3.4-4.6), with a risk difference of 3.1 (2.5-3.7), per 100,000 persons vaccinated following the second dose. The highest SIR was 25.6 (15.5-37.5) in the 5-19 years age group, following the second dose of the vaccine, with an estimated five additional myo/pericarditis cases per 100,000 persons vaccinated. A statistically significant increased SIR of single organ cutaneous vasculitis (SOCV) was also observed following the first dose of BNT162b2 in the 20-39 years age group only. CONCLUSIONS A statistically significant association between BNT162b2 vaccination and myo/pericarditis was observed. This association has been confirmed internationally. BNT162b2 was not found to be associated with the other AESIs investigated, except for SOCV following the first dose of BNT162b2 in the 20-39 years age group only, providing reassurances around the safety of the vaccine.
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Affiliation(s)
- Muireann Walton
- Ministry of Health New Zealand, 133 Molesworth Street, Wellington, 6011 New Zealand
- Te Whatu Ora, Health New Zealand, Wellington, New Zealand
| | - Vadim Pletzer
- Ministry of Health New Zealand, 133 Molesworth Street, Wellington, 6011 New Zealand
- Te Whatu Ora, Health New Zealand, Wellington, New Zealand
| | - Thomas Teunissen
- Ministry of Health New Zealand, 133 Molesworth Street, Wellington, 6011 New Zealand
| | - Thomas Lumley
- Faculty of Science, Statistics, University of Auckland, Science Centre - MATHPHYSIC - Bldg 303, 38 Princes Street, Auckland, 1010 New Zealand
| | - Timothy Hanlon
- Ministry of Health New Zealand, 133 Molesworth Street, Wellington, 6011 New Zealand
- Te Whatu Ora, Health New Zealand, Wellington, New Zealand
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16
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Cameron-Blake E, Tatlow H, Andretti B, Boby T, Green K, Hale T, Petherick A, Phillips T, Pott A, Wade A, Zha H. A panel dataset of COVID-19 vaccination policies in 185 countries. Nat Hum Behav 2023; 7:1402-1413. [PMID: 37414885 PMCID: PMC10444623 DOI: 10.1038/s41562-023-01615-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 04/28/2023] [Indexed: 07/08/2023]
Abstract
We present a panel dataset of COVID-19 vaccine policies, with data from 01 January 2020 for 185 countries and a number of subnational jurisdictions, reporting on vaccination prioritization plans, eligibility and availability, cost to the individual and mandatory vaccination policies. For each of these indicators, we recorded who is targeted by a policy using 52 standardized categories. These indicators document a detailed picture of the unprecedented scale of international COVID-19 vaccination rollout and strategy, indicating which countries prioritized and vaccinated which groups, when and in what order. We highlight key descriptive findings from these data to demonstrate uses for the data and to encourage researchers and policymakers in future research and vaccination planning. Numerous patterns and trends begin to emerge. For example: 'eliminator' countries (those that aimed to prevent virus entry into the country and community transmission) tended to prioritize border workers and economic sectors, while 'mitigator' countries (those that aimed to reduce the impact of community transmission) tended to prioritize the elderly and healthcare sectors for the first COVID-19 vaccinations; high-income countries published prioritization plans and began vaccinations earlier than low- and middle-income countries. Fifty-five countries were found to have implemented at least one policy of mandatory vaccination. We also demonstrate the value of combining this data with vaccination uptake rates, vaccine supply and demand data, and with further COVID-19 epidemiological data.
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Affiliation(s)
- Emily Cameron-Blake
- Blavatnik School of Government, University of Oxford, Oxford, UK.
- School of Social and Political Science, University of Edinburgh, Edinburgh, UK.
| | - Helen Tatlow
- Blavatnik School of Government, University of Oxford, Oxford, UK
| | - Bernardo Andretti
- Blavatnik School of Government, University of Oxford, Oxford, UK
- Brazilian School of Public and Business Administration, Getulio Vargas Foundation, Rio de Janeiro, Brazil
| | - Thomas Boby
- Blavatnik School of Government, University of Oxford, Oxford, UK
| | - Kaitlyn Green
- Blavatnik School of Government, University of Oxford, Oxford, UK
| | - Thomas Hale
- Blavatnik School of Government, University of Oxford, Oxford, UK
| | - Anna Petherick
- Blavatnik School of Government, University of Oxford, Oxford, UK
| | - Toby Phillips
- Blavatnik School of Government, University of Oxford, Oxford, UK
| | - Annalena Pott
- Blavatnik School of Government, University of Oxford, Oxford, UK
| | - Adam Wade
- Blavatnik School of Government, University of Oxford, Oxford, UK
| | - Hao Zha
- Blavatnik School of Government, University of Oxford, Oxford, UK
- Bartlett School of Sustainable Construction, University College London, London, UK
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17
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Fu LT, Qu ZL, Zeng X, Li LZ, Lan R, Zhou Y. Spatiotemporal dynamics of confirmed case distribution during the COVID-19 pandemic in China: data comparison between 2020/04-2020/08 and 2021/04-2021/08. Sci Rep 2023; 13:11896. [PMID: 37482580 PMCID: PMC10363524 DOI: 10.1038/s41598-023-39139-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 07/20/2023] [Indexed: 07/25/2023] Open
Abstract
The COVID-19 pandemic across Chinese mainland was gradually stabilized at a low level with sporadic outbreaks, before the emergence of Omicron variant. Apart from non-pharmacological interventions (NPIs), COVID-19 vaccine has also been implemented to prevent and control the pandemic since early 2021. Although many aspects have been focused, the change of the spatiotemporal distribution of COVID-19 epidemic across Chinese mainland responding to the change of prevention and control measures were less concerned. Here, we collected the confirmed case data (including domestic cases and overseas imported cases) across Chinese mainland during both 2020/04-2020/08 and 2021/04-2021/08, and then conducted a preliminary data comparison on the spatiotemporal distribution of confirmed cases during the identical period between the two years. Distribution patterns were evaluated both qualitatively by classification method and quantitatively through employing coefficient of variation. Results revealed significant differences in the homogeneity of spatiotemporal distributions of imported or domestic cases between the two years, indicating that the important effect of the adjustment of prevention and control measures on the epidemic evolution. The findings here enriched our practical experience of COVID-19 prevention and control. And, the collected data here might be helpful for improving or verifying spatiotemporally dynamic models of infectious diseases.
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Affiliation(s)
- Lin-Tao Fu
- School of Architecture and Civil Engineering, Chengdu University, Chengdu, 610106, China.
| | - Zhong-Ling Qu
- School of Architecture and Civil Engineering, Chengdu University, Chengdu, 610106, China
| | - Xin Zeng
- School of Architecture and Civil Engineering, Chengdu University, Chengdu, 610106, China
| | - Liang-Zhi Li
- School of Architecture and Civil Engineering, Chengdu University, Chengdu, 610106, China
| | - Run Lan
- School of Architecture and Civil Engineering, Chengdu University, Chengdu, 610106, China
| | - Yu Zhou
- School of Architecture and Civil Engineering, Chengdu University, Chengdu, 610106, China
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18
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Chambers ST, Storer M, Scott-Thomas A, Slow S, Williman J, Epton M, Murdoch DR, Metcalf S, Carr A, Isenman H, Maze M. Adjunctive intravenous then oral vitamin C for moderate and severe community-acquired pneumonia in hospitalized adults: feasibility of randomized controlled trial. Sci Rep 2023; 13:11879. [PMID: 37482552 PMCID: PMC10363531 DOI: 10.1038/s41598-023-37934-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 06/29/2023] [Indexed: 07/25/2023] Open
Abstract
Patients hospitalised with community acquired pneumonia (CAP) have low peripheral blood vitamin C concentrations and limited antioxidant capacity. The feasibility of a trial of vitamin C supplementation to improve patient outcomes was assessed. Participants with moderate and severe CAP (CURB-65 ≥ 2) on intravenous antimicrobial treatment were randomised to either intravenous vitamin C (2.5 g 8 hourly) or placebo before switching to oral intervention (1 g tds) for 7 days when they were prescribed oral antimicrobial therapy. Of 344 patients screened 75 (22%) were randomised and analysed. The median age was 76 years, and 43 (57%) were male. In each group, one serious adverse event that was potentially intervention related occurred, and one subject discontinued treatment. Vitamin C concentrations were 226 µmol/L in the vitamin C group and 19 µmol/L in the placebo group (p < 0.001) after 3 intravneous doses. There were no signficant differences between the vitamin C and placebo groups for death within 28 days (0 vs. 2; p = 0.49), median length of stay (69 vs. 121 h; p = 0.07), time to clinical stability (22 vs. 49 h; p = 0.08), or readmission within 30 days (1 vs. 4; p = 0.22). The vitamin C doses given were safe, well tolerated and saturating. A randomised controlled trial to assess the efficacy of vitamin C in patients with CAP would require 932 participants (CURB-65 ≥ 2) to observe a difference in mortality and 200 participants to observe a difference with a composite endpoint such as mortality plus discharge after 7 days in hospital. These studies are feasible in a multicentre setting.
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Affiliation(s)
- Stephen T Chambers
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand.
| | - Malina Storer
- Canterbury Respiratory Research Group, Canterbury District Health Board, Christchurch, New Zealand
| | - Amy Scott-Thomas
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - Sandy Slow
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
- Department of Agricultural Sciences, Lincoln University, Lincoln, New Zealand
| | - Jonathan Williman
- Biostatistics and Computation Biology Unit, University of Otago, Christchurch, New Zealand
| | - Michael Epton
- Canterbury Respiratory Research Group, Canterbury District Health Board, Christchurch, New Zealand
| | - David R Murdoch
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - Sarah Metcalf
- Department of Infectious Diseases, Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand
| | - Anitra Carr
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - Heather Isenman
- Department of Infectious Diseases, Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand
| | - Michael Maze
- Canterbury Respiratory Research Group, Canterbury District Health Board, Christchurch, New Zealand
- Department of Medicine, University of Otago, Christchurch, New Zealand
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19
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Saengtabtim K, Tang J, Leelawat N, Egawa S, Suppasri A, Imamura F. Universal health coverage mitigated COVID-19 health-related consequences in Asia Oceania. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2023; 92:103725. [PMID: 37193307 PMCID: PMC10141793 DOI: 10.1016/j.ijdrr.2023.103725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/17/2023] [Accepted: 04/26/2023] [Indexed: 05/18/2023]
Abstract
The COVID-19 pandemic has been a continual challenge since 2020, and it continues to impact people and industries as a disaster caused by a biological hazard. This study examined universal health coverage (UHC) scores in relation to the performance in combating COVID-19 in the Southeast Asian region (SEAR) and the Western Pacific region (WPR), along with the State Party Self-Assessment Annual Reporting (SPAR) index under the international health regulations (IHC). The numbers of infections and deaths per million population from December 2019 to June 2022 were used as primary outcomes to measure countries' performance. Countries with UHC scores of 63 or higher had a significantly lower number of infected patients and deaths. In addition, several inter-capacity correlations within the SPAR capacities, including with C8 (the National Health Emergency Framework), as well as a very strong correlation to C4 (Food Safety), C5 (Laboratory), and C7 (Human Resources). Furthermore, C9 (Health Service Provisions) has a very strong correlation to C1 (Legislation and Financing), C2 (International Health Regulation Coordination and a National IHR Focal Point function), and C4 (Food Safety), suggesting that the capability to manage an emerging infectious disease form blocks of capacities. In conclusion, UHC clearly mitigated the health-related consequences of COVID-19 in South-East Asia Region (SEAR) and Western Pacific Region (WPR). Investigating the correlation between the SPAR capacities and UHC is a promising approach for future research, including the importance of the provision of health services, points of entry, and, most importantly, risk communications as critical factors for managing pandemic. This study constitutes a good opportunity to apply the SPAR index to define which capacities correlate with the outcome of the pandemic in terms of infections and deaths.
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Affiliation(s)
- Kumpol Saengtabtim
- Department of Industrial Engineering, Faculty of Engineering, Chulalongkorn University, 254 Phayathai Road, Pathumwan, Bangkok, 10330, Thailand
| | - Jing Tang
- International School of Engineering, Faculty of Engineering, Chulalongkorn University, 254 Phayathai Road, Pathumwan, Bangkok, 10330, Thailand
- Disaster and Risk Management Information Systems Research Unit, Chulalongkorn University, 254 Phayathai Road, Pathumwan, Bangkok, 10330, Thailand
| | - Natt Leelawat
- Department of Industrial Engineering, Faculty of Engineering, Chulalongkorn University, 254 Phayathai Road, Pathumwan, Bangkok, 10330, Thailand
- Disaster and Risk Management Information Systems Research Unit, Chulalongkorn University, 254 Phayathai Road, Pathumwan, Bangkok, 10330, Thailand
| | - Shinichi Egawa
- International Research Institute of Disaster Science, Tohoku University, 468-1 Aoba, Aramaki, Aoba-ku, Sendai, Miyagi, 980-8572, Japan
- International Cooperation for Disaster Medicine, Tohoku University, 468-1 Aoba, Aramaki, Aoba-ku, Sendai, Miyagi, 980-8572, Japan
| | - Anawat Suppasri
- International Research Institute of Disaster Science, Tohoku University, 468-1 Aoba, Aramaki, Aoba-ku, Sendai, Miyagi, 980-8572, Japan
| | - Fumihiko Imamura
- International Research Institute of Disaster Science, Tohoku University, 468-1 Aoba, Aramaki, Aoba-ku, Sendai, Miyagi, 980-8572, Japan
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20
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Bayly H, Stoddard M, Egeren DV, Murray EJ, Raifman J, Chakravarty A, White LF. Looking under the lamp-post: quantifying the performance of contact tracing in the United States during the SARS-CoV-2 pandemic. RESEARCH SQUARE 2023:rs.3.rs-2953875. [PMID: 37333276 PMCID: PMC10274953 DOI: 10.21203/rs.3.rs-2953875/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Contact tracing forms a crucial part of the public-health toolbox in mitigating and understanding emergent pathogens and nascent disease outbreaks. Contact tracing in the United States was conducted during the pre-Omicron phase of the ongoing COVID-19 pandemic. This tracing relied on voluntary reporting and responses, often using rapid antigen tests (with a high false negative rate) due to lack of accessibility to PCR tests. These limitations, combined with SARS-CoV-2's propensity for asymptomatic transmission, raise the question "how reliable was contact tracing for COVID-19 in the United States"? We answered this question using a Markov model to examine the efficiency with which transmission could be detected based on the design and response rates of contact tracing studies in the United States. Our results suggest that contact tracing protocols in the U.S. are unlikely to have identified more than 1.65% (95% uncertainty interval: 1.62%-1.68%) of transmission events with PCR testing and 0.88% (95% uncertainty interval 0.86%-0.89%) with rapid antigen testing. When considering an optimal scenario, based on compliance rates in East Asia with PCR testing, this increases to 62.7% (95% uncertainty interval: 62.6%-62.8%). These findings highlight the limitations in interpretability for studies of SARS-CoV-2 disease spread based on U.S. contact tracing and underscore the vulnerability of the population to future disease outbreaks, for SARS-CoV-2 and other pathogens.
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21
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Gozzi N, Chinazzi M, Dean NE, Longini IM, Halloran ME, Perra N, Vespignani A. Estimating the impact of COVID-19 vaccine inequities: a modeling study. Nat Commun 2023; 14:3272. [PMID: 37277329 DOI: 10.1038/s41467-023-39098-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 05/25/2023] [Indexed: 06/07/2023] Open
Abstract
Access to COVID-19 vaccines on the global scale has been drastically hindered by structural socio-economic disparities. Here, we develop a data-driven, age-stratified epidemic model to evaluate the effects of COVID-19 vaccine inequities in twenty lower middle and low income countries (LMIC) selected from all WHO regions. We investigate and quantify the potential effects of higher or earlier doses availability. In doing so, we focus on the crucial initial months of vaccine distribution and administration, exploring counterfactual scenarios where we assume the same per capita daily vaccination rate reported in selected high income countries. We estimate that more than 50% of deaths (min-max range: [54-94%]) that occurred in the analyzed countries could have been averted. We further consider scenarios where LMIC had similarly early access to vaccine doses as high income countries. Even without increasing the number of doses, we estimate an important fraction of deaths (min-max range: [6-50%]) could have been averted. In the absence of the availability of high-income countries, the model suggests that additional non-pharmaceutical interventions inducing a considerable relative decrease of transmissibility (min-max range: [15-70%]) would have been required to offset the lack of vaccines. Overall, our results quantify the negative impacts of vaccine inequities and underscore the need for intensified global efforts devoted to provide faster access to vaccine programs in low and lower-middle-income countries.
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Affiliation(s)
- Nicolò Gozzi
- Networks and Urban Systems Centre, University of Greenwich, London, UK
- ISI Foundation, Turin, Italy
| | - Matteo Chinazzi
- Laboratory for the Modeling of Biological and Socio-technical Systems, Northeastern University, Boston, MA, USA
| | - Natalie E Dean
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
| | - Ira M Longini
- Department of Biostatistics, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - M Elizabeth Halloran
- Fred Hutchinson Cancer Center, Seattle, WA, USA
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Nicola Perra
- Laboratory for the Modeling of Biological and Socio-technical Systems, Northeastern University, Boston, MA, USA.
- School of Mathematical Sciences, Queen Mary University, London, UK.
| | - Alessandro Vespignani
- Laboratory for the Modeling of Biological and Socio-technical Systems, Northeastern University, Boston, MA, USA
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22
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Ledesma JR, Isaac CR, Dowell SF, Blazes DL, Essix GV, Budeski K, Bell J, Nuzzo JB. Evaluation of the Global Health Security Index as a predictor of COVID-19 excess mortality standardised for under-reporting and age structure. BMJ Glob Health 2023; 8:e012203. [PMID: 37414431 PMCID: PMC10335545 DOI: 10.1136/bmjgh-2023-012203] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 05/29/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Previous studies have observed that countries with the strongest levels of pandemic preparedness capacities experience the greatest levels of COVID-19 burden. However, these analyses have been limited by cross-country differentials in surveillance system quality and demographics. Here, we address limitations of previous comparisons by exploring country-level relationships between pandemic preparedness measures and comparative mortality ratios (CMRs), a form of indirect age standardisation, of excess COVID-19 mortality. METHODS We indirectly age standardised excess COVID-19 mortality, from the Institute for Health Metrics and Evaluation modelling database, by comparing observed total excess mortality to an expected age-specific COVID-19 mortality rate from a reference country to derive CMRs. We then linked CMRs with data on country-level measures of pandemic preparedness from the Global Health Security (GHS) Index. These data were used as input into multivariable linear regression analyses that included income as a covariate and adjusted for multiple comparisons. We conducted a sensitivity analysis using excess mortality estimates from WHO and The Economist. RESULTS The GHS Index was negatively associated with excess COVID-19 CMRs (table 2; β= -0.21, 95% CI= -0.35 to -0.08). Greater capacities related to prevention (β= -0.11, 95% CI= -0.22 to -0.00), detection (β= -0.09, 95% CI= -0.19 to -0.00), response (β = -0.19, 95% CI= -0.36 to -0.01), international commitments (β= -0.17, 95% CI= -0.33 to -0.01) and risk environments (β= -0.30, 95% CI= -0.46 to -0.15) were each associated with lower CMRs. Results were not replicated using excess mortality models that rely more heavily on reported COVID-19 deaths (eg, WHO and The Economist). CONCLUSION The first direct comparison of COVID-19 excess mortality rates across countries accounting for under-reporting and age structure confirms that greater levels of preparedness were associated with lower excess COVID-19 mortality. Additional research is needed to confirm these relationships as more robust national-level data on COVID-19 impact become available.
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Affiliation(s)
- Jorge Ricardo Ledesma
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
| | | | - Scott F Dowell
- Bill & Melinda Gates Foundation, Seattle, Washington, USA
| | - David L Blazes
- Bill & Melinda Gates Foundation, Seattle, Washington, USA
| | | | | | | | - Jennifer B Nuzzo
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
- Pandemic Center, Brown University School of Public Health, Providence, Rhode Island, USA
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23
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Liu LS, Jia X, Zhu A, Ran GJ, Johnston D, Siegert R, Gong Y, French N, Lu J. Measuring the missing: Knowledge, risk perceptions and self-protection practices of COVID-19 among the Asian population in New Zealand: An online survey. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2023:1-18. [PMID: 37361274 PMCID: PMC10193356 DOI: 10.1007/s10389-023-01926-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 04/28/2023] [Indexed: 06/28/2023]
Abstract
Aim Asians are the second largest and fastest growing non-European population in New Zealand but are under-researched in terms of their COVID-19 pandemic response. The paper aims to illustrates Asians' risk perceptions and knowledge of COVID-19, and self-protection practices to avoid infection and prevent community transmission. Subject and methods An online survey was used to collect data and received 402 valid responses. Data analyses included: 1) a descriptive analysis by using Chi-square tests and a Kruskal-Wallis rank sum tests to explore associations between responses and the four demographic variables (i.e. age, gender, country of origin/ethnicity, and region); and 2) a correlation analysis between different survey objectives. Results The descriptive analysis of the survey found that while ethnicity (within the Asian category) was the most influential variable that resulted in varying responses to many questions, gender and age were other two important variables in influencing the answering patterns. The correlation analysis found a positive correlation between the perceived 'dangerousness' of COVID-19 and respondents' overall compliance behaviour to New Zealand authorities' recommendations to prevent spread of COVID-19. Conclusion The majority of the respondents provided correct answers to the questions about the vulnerable populations, symptoms, asymptomatic transmission and potential sequelae of COVID-19; however, their understanding of the availability of a cure for, and the incubation period of COVID-19 was not consistent with the official information. The research also found that the higher perceived dangerousness of COVID-19, the better compliance to self-protection practices among the surveyed population.
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Affiliation(s)
- Liangni Sally Liu
- School of Humanities, Media and Creative Communication, Massey University, Auckland, New Zealand
| | - Xiaoyun Jia
- Institute of Governance & School of Politics and Public Administration, Shandong University, Qingdao, China
| | - Andrew Zhu
- Trace Research Ltd, Auckland, New Zealand
| | - Guanyu Jason Ran
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
| | - David Johnston
- Joint Centre for Disaster Research, Massey University, Wellington, New Zealand
| | - Richard Siegert
- Department of Psychology & Neuroscience, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Yuan Gong
- School of Humanities, Media and Creative Communication, Massey University, Auckland, New Zealand
| | - Nigel French
- Infectious Diseases Research Centre, Hopkirk Research Institute, Massey University, Palmerston North, New Zealand
| | - Jun Lu
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
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24
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van Kessel R, Kyriopoulos I, Mastylak A, Mossialos E. Changes in digital healthcare search behavior during the early months of the COVID-19 pandemic: A study of six English-speaking countries. PLOS DIGITAL HEALTH 2023; 2:e0000241. [PMID: 37126489 PMCID: PMC10150970 DOI: 10.1371/journal.pdig.0000241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/22/2023] [Indexed: 05/02/2023]
Abstract
Public interest is an important component influencing the likelihood of successfully implementing digital healthcare. The onset of the COVID-19 pandemic allowed us to assess how public interest in digital health changed in response to disruptions in traditional health services. In this study, we used a difference-in-differences approach to determine how digital healthcare search behavior shifted during the early months of the COVID-19 pandemic compared to the same period in 2019 across six English-speaking countries: the United States, Canada, the United Kingdom, New Zealand, Australia, and Ireland. In most cases, we observed that the official declaration of the COVID-19 pandemic on 11 March 2020 was associated with a significant overall increase in the volume of digital healthcare searches. We also found notable heterogeneity between countries in terms of the keywords that were used to search for digital healthcare, which could be explained by linguistic differences across countries or the different national digital health landscapes. Since online searches could be an initial step in the pathway to accessing health services, future studies should investigate under what circumstances increased public interest translates into demand for and utilization of digital healthcare.
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Affiliation(s)
- Robin van Kessel
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
- Department of International Health, Care and Public Health Research Institute (CAPHRI), Maastricht University, The Netherlands
- Gravitate Health, European Patients' Forum, Brussels, Belgium
| | - Ilias Kyriopoulos
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Alicja Mastylak
- Department of International Health, Care and Public Health Research Institute (CAPHRI), Maastricht University, The Netherlands
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
| | - Elias Mossialos
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
- Institute of Global Health Innovation, Imperial College London, London, United Kingdom
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25
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Zhao T, Liu H, Bulloch G, Jiang Z, Cao Z, Wu Z. The influence of the COVID-19 pandemic on identifying HIV/AIDS cases in China: an interrupted time series study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 36:100755. [PMID: 37360868 PMCID: PMC10072954 DOI: 10.1016/j.lanwpc.2023.100755] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/23/2023] [Accepted: 03/16/2023] [Indexed: 04/08/2023]
Abstract
Background The COVID-19 pandemic has caused significant global public health challenges, and impacted HIV testing and reporting worldwide. We aimed to estimate the impact of COVID-19 polices on identifying HIV/AIDS cases in China from 2020 to 2022. Methods We used an interrupted time series (ITS) design and seasonal autoregressive integrated moving average intervention (SARIMA Intervention) model. Monthly reported data on HIV/AIDS cases were extracted from the National Bureau of Disease Control and Prevention of China from January 2004 to August 2022. Data on Stringency Index (SI) and Economic Support Index (ESI) from January 22, 2020 to August 31, 2022 were extracted from the Oxford COVID-19 Government Response Tracker (OxCGRT). Using these, a SARIMA-Intervention model was constructed to evaluate the association between COVID-19 polices and monthly reported HIV/AIDS case numbers from January 2004 to August 2022 using auto.arima () function from R. The absolute percentage errors (APEs) compared the expected numbers generated by the SARIMA-Intervention model with actual numbers of HIV/AIDS, and was the primary outcome of this study. A second counterfactual model estimated HIV/AIDS case numbers if COVID-19 hadn't occurred in December 2019, and the mean difference between actual and predicted numbers were calculated. All statistical analyses were performed in R software (version 4.2.1) and EmpowerStats 2.0 and a P < 0.05 was considered statistically significant. Findings The SARIMA-Intervention model indicated HIV/AIDS monthly reported cases were inversely and significantly correlated with stricter lockdown and COVID-19 related polices (Coefficient for SI = -231.24, 95% CI: -383.17, -79.32) but not with economic support polices (Coefficient for ESI = 124.27, 95% CI: -309.84, 558.38). APEs of the SARIMA-Intervention model for prediction of HIV/AIDS cases from January 2022 through August 2022, were -2.99, 5.08, -13.64, -34.04, -2.76, -1.52, -1.37 and -2.47 respectively, indicating good accuracy and underreporting of cases during COVID-19. The counterfactual model estimates between January 2020 and August 2022 an additional 1314 HIV/AIDS cases should have been established monthly if COVID-19 hadn't occurred. Interpretation The COVID-19 pandemic influenced the allocation and acquisition of medical resources which impacted accurate monthly reporting of HIV in China. Interventions that promote continuous HIV testing and ensure the adequate provision of HIV services including remote delivery of HIV testing services (HIV self-testing) and online sexual counseling services are necessary during pandemics in future. Funding Ministry of Science and Technology of the People's Republic of China (The grant number: 2020YFC0846300) and Fogarty International Center, National Institutes of Health, USA (The grant number: G11TW010941).
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Affiliation(s)
- Tianming Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haixia Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Gabriella Bulloch
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Zhen Jiang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhaobing Cao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zunyou Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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26
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Loitz CC, Johansen S, Johnston JC, Strain KL, Patterson K, Chambers P, Devolin M. Exploring the Alberta Health Services COVID-19 provincial public health integrated outbreak prevention, preparedness, management, and response interventions to support congregate and communal living sites in Alberta. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2023; 114:218-228. [PMID: 36787032 PMCID: PMC9927052 DOI: 10.17269/s41997-023-00749-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 01/24/2023] [Indexed: 02/15/2023]
Abstract
SETTING On March 17, 2020, a state of public health emergency was declared in Alberta under the Public Health Act in response to the COVID-19 pandemic. Congregate and communal living sites were environments with a high risk of exposure to and transmission of COVID-19. Consequently, provincial efforts to prevent and manage COVID-19 were required and prioritized. INTERVENTION During the first 9 months of the pandemic, vaccines were unavailable and alternate strategies were used to prevent and manage COVID-19 (e.g., physical distancing, masking, symptom screening, testing, isolating cases). Alberta Health Services worked with local, provincial, and First Nations and Inuit Health Branch stakeholders to deliver interventions to support congregate and communal living sites. Interventions included resources and site visits to support prevention and preparedness, and the creation of a coordinated response line to serve as a single point of contact to access information and services in the event of an outbreak (e.g., guidance, testing, personal protective equipment, reporting). OUTCOMES Data from an internal monitoring dashboard informed intervention uptake and use. Online survey results found high levels of awareness, acceptability, appropriateness, and use of the interventions among congregate and communal living site administrators (n = 550). Recommendations were developed from reported experiences, challenges, and facilitators, and processes were improved. IMPLICATIONS Provincially coordinated prevention, preparedness, and outbreak management interventions supported congregate and communal living sites. Efforts to further develop adaptive system-level approaches for prevention and preparedness, in addition to communication and information sharing in complex rapidly changing contexts, could benefit future public health emergencies.
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Affiliation(s)
- Christina C Loitz
- Population and Public Health, Alberta Health Services, Edmonton, AB, Canada.
| | - Sandra Johansen
- Population and Public Health, Alberta Health Services, Calgary, AB, Canada
| | - J Cyne Johnston
- Population and Public Health, Alberta Health Services, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Keri-Lynn Strain
- Population and Public Health, Alberta Health Services, Calgary, AB, Canada
| | - Kara Patterson
- Population and Public Health, Alberta Health Services, Calgary, AB, Canada
| | - Patricia Chambers
- Provincial Clinical Programs and Virtual Health, Alberta Health Services, Calgary, AB, Canada
| | - Maureen Devolin
- Population and Public Health, Alberta Health Services, Calgary, AB, Canada
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27
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Wang Y, Zhang C. Impact of policy response on health protection and economic recovery in OECD and BRIICS countries during the early stages of the COVID-19 pandemic. Public Health 2023; 217:7-14. [PMID: 36827784 PMCID: PMC9870755 DOI: 10.1016/j.puhe.2023.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/05/2022] [Accepted: 01/10/2023] [Indexed: 01/25/2023]
Abstract
OBJECTIVES During the early stages of the COVID-19 pandemic, the full reopening of the economy typically accelerated viral transmission. This study aims to determine whether policy response could contribute to the dual objective of both reducing the spread of the epidemic and revitalising economic activities. STUDY DESIGN This is a longitudinal study of Organization for Economic Cooperation and Development (OECD) and Brazil, Russia, India, Indonesia, China, and South Africa (BRIICS) from the first quarter (Q1) of 2020 to the same period of 2021. METHODS From a health-economic perspective, this study established a framework to illustrate the following outcomes: suppression-prosperity, outbreak-stagnancy, outbreak-prosperity and suppression-stagnancy scenarios. Multinomial logistic models were used to analyse the associations between policy response with both the pandemic and the economy. The study further examined two subtypes of policy response, stringency/health measures and economic support measures, separately. The probabilities of the different scenarios were estimated. RESULTS Economic prosperity and epidemic suppression were significantly associated with policy response. The effects of policy response on health-economic scenarios took the form of inverse U-shapes with the increase in intensity. 'Leptokurtic', 'bimodal' and 'long-tailed' curves demonstrated the estimated possibilities of suppression-prosperity, outbreak-prosperity and suppression-stagnancy scenarios, respectively. In addition, stringency/health policies followed the inverted U-shaped pattern, whereas economic support policies showed a linear pattern. CONCLUSIONS It was possible to achieve the dual objective of economic growth and epidemic control simultaneously, and the effects of policy response were shaped like an inverse U. These findings provide a new perspective for balancing the economy with public health during the early stages of the pandemic.
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Affiliation(s)
| | - C. Zhang
- Corresponding author. Department of Sociology, School of Social Sciences, Tsinghua University, Beijing, 100084, China. Tel.: +86 10 62794966
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28
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Sonder GJ, Grey C, Anglemyer A, Tukuitonga C, Hill PC, Sporle A, Ryan D. The August 2020 COVID-19 outbreak in Aotearoa, New Zealand: Delayed contact tracing for Pacific people contributes to widening health disparities. IJID REGIONS 2023; 6:177-183. [PMID: 36741984 PMCID: PMC9890878 DOI: 10.1016/j.ijregi.2023.01.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 02/04/2023]
Abstract
Background After COVID-19 arrived in New Zealand, a national system was developed to improve the efficiency of contact tracing. The first outbreak was followed by a period of 'COVID-19 elimination', until a community outbreak occurred in August 2020. We describe the characteristics of cases and their contacts during this outbreak, focused on the results of contact tracing. Methods COVID-19 case data from the national surveillance database were linked to contacts from the national contact tracing database. Demographic and clinical characteristics of cases, number of contacts, and timeliness of contact tracing were analysed by ethnicity. Findings Most of the 179 cases were Pacific people (59%) or Māori (25%), living in areas of high socioeconomic deprivation, who had higher rates of comorbidity and accounted for almost all (21/22) hospitalisations, all 8 ICU admissions and all 3 deaths. Only 6% belonged to the European majority ethnic group. Of 2,528 registered contacts, 46% were Pacific, 14% Māori and 19% European. Only contacts that were reached were registered. Overall, 41% of contacts were reached within 4 days of onset of disease of the case, which was significantly lower for Pacific (31%) than for other ethnic groups. Interpretation Our findings confirm the greater health burden that ethnic minorities face from COVID-19. The significant delay in the timeliness of care for Pacific people shows that the public health response was inequitable for those at highest risk. Tailored public health responses and better registration of marginalised groups are necessary to provide better access to services and to improve insights for optimal future outbreak management.
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Affiliation(s)
- Gerard Jb Sonder
- Pacific Perspectives Ltd, PO Box 8010, Wellington 6143, New Zealand.,Department of Internal Medicine, Amsterdam Infection & Immunity Institute (AIII), Amsterdam UMC, location Academic Medical Center, the Netherlands
| | - Corina Grey
- Pacific Perspectives Ltd, PO Box 8010, Wellington 6143, New Zealand.,Department of General Practice and Primary Health Care, School of Population Health, University of Auckland
| | - Andrew Anglemyer
- Department of Preventive and Social Medicine, Division of Health Sciences, University of Otago, Dunedin, New Zealand.,Health Intelligence Team, Institute for Environmental Science and Research, Wellington, New Zealand
| | - Collin Tukuitonga
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Philip C Hill
- Centre for International Health, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Andrew Sporle
- iNZight Analytics Ltd.,Department of Statistics, The University of Auckland
| | - Debbie Ryan
- Pacific Perspectives Ltd, PO Box 8010, Wellington 6143, New Zealand
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Irizar P, Pan D, Kapadia D, Bécares L, Sze S, Taylor H, Amele S, Kibuchi E, Divall P, Gray LJ, Nellums LB, Katikireddi SV, Pareek M. Ethnic inequalities in COVID-19 infection, hospitalisation, intensive care admission, and death: a global systematic review and meta-analysis of over 200 million study participants. EClinicalMedicine 2023; 57:101877. [PMID: 36969795 PMCID: PMC9986034 DOI: 10.1016/j.eclinm.2023.101877] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 02/02/2023] [Accepted: 02/02/2023] [Indexed: 03/08/2023] Open
Abstract
Background COVID-19 has exacerbated existing ethnic inequalities in health. Little is known about whether inequalities in severe disease and deaths, observed globally among minoritised ethnic groups, relates to greater infection risk, poorer prognosis, or both. We analysed global data on COVID-19 clinical outcomes examining inequalities between people from minoritised ethnic groups compared to the ethnic majority group. Methods Databases (MEDLINE, EMBASE, EMCARE, CINAHL, Cochrane Library) were searched from 1st December 2019 to 3rd October 2022, for studies reporting original clinical data for COVID-19 outcomes disaggregated by ethnicity: infection, hospitalisation, intensive care unit (ICU) admission, and mortality. We assessed inequalities in incidence and prognosis using random-effects meta-analyses, with Grading of Recommendations Assessment, Development, and Evaluation (GRADE) use to assess certainty of findings. Meta-regressions explored the impact of region and time-frame (vaccine roll-out) on heterogeneity. PROSPERO: CRD42021284981. Findings 77 studies comprising over 200,000,000 participants were included. Compared with White majority populations, we observed an increased risk of testing positive for infection for people from Black (adjusted Risk Ratio [aRR]:1.78, 95% CI:1.59-1.99, I2 = 99.1), South Asian (aRR:3.00, 95% CI:1.59-5.66, I2 = 99.1), Mixed (aRR:1.64, 95% CI:1.02-1.67, I2 = 93.2) and Other ethnic groups (aRR:1.36, 95% CI:1.01-1.82, I2 = 85.6). Black, Hispanic, and South Asian people were more likely to be seropositive. Among population-based studies, Black and Hispanic ethnic groups and Indigenous peoples had an increased risk of hospitalisation; Black, Hispanic, South Asian, East Asian and Mixed ethnic groups and Indigenous peoples had an increased risk of ICU admission. Mortality risk was increased for Hispanic, Mixed, and Indigenous groups. Smaller differences were seen for prognosis following infection. Following hospitalisation, South Asian, East Asian, Black and Mixed ethnic groups had an increased risk of ICU admission, and mortality risk was greater in Mixed ethnic groups. Certainty of evidence ranged from very low to moderate. Interpretation Our study suggests that systematic ethnic inequalities in COVID-19 health outcomes exist, with large differences in exposure risk and some differences in prognosis following hospitalisation. Response and recovery interventions must focus on tackling drivers of ethnic inequalities which increase exposure risk and vulnerabilities to severe disease, including structural racism and racial discrimination. Funding ESRC:ES/W000849/1.
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Affiliation(s)
- Patricia Irizar
- School of Social Sciences, University of Manchester, United Kingdom
| | - Daniel Pan
- Department of Respiratory Sciences, University of Leicester, United Kingdom
- Department of Infection and HIV Medicine, University Hospitals Leicester NHS Trust, United Kingdom
- Li Ka Shing Centre for Health Information and Discovery, Oxford Big Data Institute, University of Oxford, United Kingdom
- NIHR Leicester Biomedical Research Centre, United Kingdom
| | - Dharmi Kapadia
- School of Social Sciences, University of Manchester, United Kingdom
| | - Laia Bécares
- Department of Global Health and Social Medicine, King's College London, United Kingdom
| | - Shirley Sze
- Department of Cardiovascular Sciences, University of Leicester, United Kingdom
| | - Harry Taylor
- School of Social Sciences, University of Manchester, United Kingdom
| | - Sarah Amele
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, United Kingdom
| | - Eliud Kibuchi
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, United Kingdom
| | - Pip Divall
- University Hospitals of Leicester, Education Centre Library, Glenfield Hospital and Leicester Royal Infirmary, United Kingdom
| | - Laura J Gray
- Department of Health Sciences, University of Leicester, United Kingdom
| | - Laura B Nellums
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, United Kingdom
| | | | - Manish Pareek
- Department of Respiratory Sciences, University of Leicester, United Kingdom
- Department of Infection and HIV Medicine, University Hospitals Leicester NHS Trust, United Kingdom
- NIHR Leicester Biomedical Research Centre, United Kingdom
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30
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Grout L, Gottfreðsson M, Kvalsvig A, Baker MG, Wilson N, Summers J. Comparing COVID-19 pandemic health responses in two high-income island nations: Iceland and New Zealand. Scand J Public Health 2023:14034948221149143. [PMID: 36717984 PMCID: PMC9892804 DOI: 10.1177/14034948221149143] [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] [Indexed: 02/01/2023]
Abstract
AIMS We aimed to compare COVID-19 control measures, epidemiological characteristics and economic performance measures in two high-income island nations with small populations, favorable border control options, and relatively good outcomes: Iceland and New Zealand (NZ). METHODS We examined peer-reviewed journal articles, official websites, reports, media releases and press articles for data on pandemic preparedness and COVID-19 public health responses from 1 January 2020 to 1 June 2022 in Iceland and NZ. We calculated epidemiological characteristics of the COVID-19 pandemic, as well as measures of economic performance. RESULTS Both nations had the lowest excess mortality in the OECD from the start of the pandemic up to June 2022. Iceland pursued a mitigation strategy, never used lockdowns or officially closed its border to foreign nationals, and instead relied on extensive testing and contact tracing early in the pandemic. Meanwhile, NZ pursued an elimination strategy, used a strict national lockdown to stop transmission, and closed its international border to everyone except citizens and permanent residents going through quarantine and testing. Iceland experienced a larger decrease in gross domestic product in 2020 (relative to 2019) than NZ (-8·27% vs. -1·22%, respectively). In late 2021, NZ announced a shift to a suppression strategy and in 2022 began to reopen its border in stages, while Iceland ended all public restrictions on 25 February 2022. CONCLUSIONS
Many of Iceland's and NZ's pandemic control measures appeared successful and features of the responses in both countries could potentially be adopted by other jurisdictions to address future disease outbreaks and pandemic threats.
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Affiliation(s)
- Leah Grout
- Department of Public Health, University of Otago, Wellington, New Zealand,Leah Grout, Larner College of Medicine, University of Vermont, 89 Beaumont Avenue, Burlington, Vermont 05405, USA. E-mail:
| | - Magnús Gottfreðsson
- Faculty of Medicine, School of Health Sciences, University of Iceland,Landspitali University Hospital, Iceland
| | - Amanda Kvalsvig
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Michael G. Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Nick Wilson
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Jennifer Summers
- Department of Public Health, University of Otago, Wellington, New Zealand
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31
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Koziol-McLain J, Cowley C, Nayar S, Koti D. Impact of COVID-19 on the Health Response to Family Violence in Aotearoa New Zealand: A Qualitative Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580221146832. [PMID: 36710509 PMCID: PMC9895298 DOI: 10.1177/00469580221146832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
COVID-19 pandemic planning and response has resulted in unprecedented upheaval within health systems internationally. With a concern for increasing frequency and escalation of family violence, the so called "shadow pandemic," we wondered how health system violence intervention programs were operating during this time. In Aotearoa New Zealand, the Ministry of Health Violence Intervention Program (VIP), using a systems approach, seeks to reduce and prevent the health impacts of family violence and abuse through early identification, assessment, and referral of victims presenting to designated health services. In this qualitative descriptive study, we explored how the VIP program was impacted during the first year of the COVID-19 pandemic. Forty-one VIP coordinators and managers representing 15 of the 20 New Zealand District Health Boards and the National VIP Team participated. Across 12 focus groups (8 face to face and 4 via Zoom) and 7 individual interviews (all via Zoom) participants shared their experience navigating systems to support frontline health providers' responsiveness to people impacted by family violence during the pandemic. In our reflexive thematic analysis, we generated 3 themes: Responding to the moment, valuing relationships, and reflecting on the status quo. Our findings demonstrate the dynamic environment in which participants found creative ways to adapt to the uncertainty and engage with communities to re-shape interventions and ensure continued implementation of the program. At the same time, challenges within the system prior to the pandemic were brought into view and highlighted the need for action. These included, for example, the need for improved engagement with Māori (Indigenous people of Aotearoa New Zealand) to address long-standing health inequities. Having quality essential services for those impacted by family violence that engages with local knowledge and networks and routinely copes with uncertainty will strengthen our systems to minimize risk of harm during emergencies.
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Affiliation(s)
- Jane Koziol-McLain
- Auckland University of Technology, Auckland, New Zealand,Jane Koziol-McLain, School of Clinical Sciences, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand.
| | | | - Shoba Nayar
- Auckland University of Technology, Auckland, New Zealand
| | - Diane Koti
- Auckland University of Technology, Auckland, New Zealand
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32
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Zińczuk A, Rorat M, Jurek T. COVID-19-related excess mortality - an overview of the current evidence. ARCHIVES OF FORENSIC MEDICINE AND CRIMINOLOGY 2023; 73:33-44. [PMID: 38186033 DOI: 10.4467/16891716amsik.22.004.18214] [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: 07/02/2023] [Accepted: 07/11/2023] [Indexed: 01/09/2024] Open
Abstract
Analysis of excess deaths, defined as the difference in the total number of deaths in an emergency compared to the number of deaths expected under normal conditions, allows a more reliable assessment of the impact on health systems caused by the global threat of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2). So far, data for the two years of the pandemic (2020-2021) indicates the occurrence of 14.9 million excess deaths according to WHO (World Health Organization) estimates. The purpose of the analysis conducted was to define the concept and identify the causes of excess mortality during the COVID-19 pandemic. Inconsistent and unreliable death registration systems; overburdened health systems in low- and middle-income countries; reduced access to medical services for patients with health problems other than COVID-19; the introduction of social distancing and lockdown rules, which translated into increased deaths from psychiatric illnesses and addictions; political considerations and media messages that interfered with vaccination acceptance and adherence; and the additional impact of other natural disasters (hurricanes, floods, drought) were identified as the most important reasons for excess deaths occurrence. The correct identification of country-specific factors and the correct response and countermeasures taken appear crucial in terms of limiting the negative impact of the current pandemic, but also of future threats of a similar nature, in order to reduce excess deaths.
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Affiliation(s)
| | - Maria Rorat
- Department of Forensic Medicine, Wroclaw Medical University, Poland
| | - Tomasz Jurek
- Department of Forensic Medicine, Wroclaw Medical University, Poland
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Cheung J, Nordmeier K, Kelland S, Harrington M, Williman J, Storer M, Beaglehole B, Beckert L, Chambers ST, Epton MJ, Freeman J, Murdoch DR, Werno AM, Maze MJ. Symptom persistence and recovery among COVID-19 survivors during a limited outbreak in Canterbury, New Zealand: a prospective cohort study. Intern Med J 2023; 53:37-45. [PMID: 36114621 PMCID: PMC9538815 DOI: 10.1111/imj.15930] [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: 05/22/2022] [Accepted: 08/26/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND In Canterbury, near complete identification of coronavirus disease 2019 (COVID-19) cases during a limited outbreak provides unique insights into sequelae. AIMS The current study aimed to measure symptom persistence, time to return to normal activity, generalised anxiety and health-related quality of life (HrQoL) among COVID-19 survivors compared with uninfected participants. METHODS The authors conducted a prospective cohort study of people tested for COVID-19 by reverse transcriptase polymerase chain reaction of nasopharyngeal swabs from 1 March to 30 June 2020. They enrolled participants who tested positive and negative at a 1:2 ratio, and administered community-acquired pneumonia, 7-item generalised anxiety disorder (GAD-7) and HrQoL (RAND-36) questionnaires. RESULTS The authors recruited 145 participants, 48 with COVID-19 and 97 without COVID-19. The mean time from COVID-19 testing to completing the health questionnaire was 306 days. The mean age of patients was 46.7 years, and 70% were women. Four (8%) COVID-19-positive and eight (8%) COVID-19-negative participants required hospitalisation. Fatigue (30/48 [63%] vs 13/97 [13%]; P < 0.001), dyspnoea (13/48 [27%] vs 6/97 [6%]; P < 0.001) and chest pain (10/48 [21%] vs 1/97 [1%]; P < 0.001) were persistent in those with COVID-19. Fewer COVID-19-positive participants returned to normal activity levels (35/48 [73%] vs 94/97 97%; P < 0.001), with longer times taken (median 21 vs 14 days; P = 0.007). The GAD-7 and RAND-36 scores of both groups were similar across all anxiety and HrQoL subscales. CONCLUSIONS Persistent symptoms and longer recovery times were found in COVID-19 survivors, but not impaired generalised anxiety levels or HrQoL compared with COVID-19-uninfected participants.
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Affiliation(s)
- Jeanette Cheung
- Respiratory Medicine Department, Canterbury District Health Board, Christchurch, New Zealand
| | - Kim Nordmeier
- Respiratory Medicine Department, Canterbury District Health Board, Christchurch, New Zealand
| | - Sarah Kelland
- Respiratory Medicine Department, Canterbury District Health Board, Christchurch, New Zealand
| | - Michael Harrington
- Microbiology Department, Canterbury Health Laboratories, Christchurch, New Zealand
| | - Jonathan Williman
- Department of Population Health, University of Otago, Christchurch, New Zealand
| | - Malina Storer
- Respiratory Medicine Department, Canterbury District Health Board, Christchurch, New Zealand
| | - Ben Beaglehole
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Lutz Beckert
- Respiratory Medicine Department, Canterbury District Health Board, Christchurch, New Zealand
| | - Stephen T Chambers
- Department of Pathology and Biomedical Sciences, University of Otago, Christchurch, New Zealand
| | - Michael J Epton
- Respiratory Medicine Department, Canterbury District Health Board, Christchurch, New Zealand
| | - Josh Freeman
- Microbiology Department, Canterbury Health Laboratories, Christchurch, New Zealand
| | - David R Murdoch
- Microbiology Department, Canterbury Health Laboratories, Christchurch, New Zealand.,Department of Pathology and Biomedical Sciences, University of Otago, Christchurch, New Zealand
| | - Anja M Werno
- Microbiology Department, Canterbury Health Laboratories, Christchurch, New Zealand
| | - Michael J Maze
- Respiratory Medicine Department, Canterbury District Health Board, Christchurch, New Zealand.,Department of Medicine, University of Otago, Christchurch, New Zealand
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Manca F, Pawlak J, Sivakumar A. Impact of perceptions and attitudes on air travel choices in the post-COVID-19 era: A cross-national analysis of stated preference data. TRAVEL BEHAVIOUR & SOCIETY 2023; 30:220-239. [PMID: 36247181 PMCID: PMC9550670 DOI: 10.1016/j.tbs.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 10/04/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic and the consequent travel restrictions have had an unprecedented impact on the air travel market. However, a rigorous analysis of the potential role of safety perceptions and attitudes towards COVID-19 interventions on future air passenger choices has been lacking to date. To investigate this matter, 1469 individuals were interviewed between April and September 2020 in four multi-airport cities (London, New York City, Sao Paulo, Shanghai). The core analysis draws upon data from a set of stated preference (SP) experiments in which respondents were asked to reflect on a hypothetical air travel journey taking place when travel restrictions are lifted but there is still a risk of infection. The hybrid choice model results show that alongside traditional attributes, such as fare, duration and transfer, attitudinal and safety perception factors matter to air passengers when making future air travel choices. The cross-national analysis points towards differences in responses across the cities to stem from culturally-driven attitudes towards interpersonal distance and personal space. We also report the willingness to pay for travel attributes under the expected future conditions and discuss post-pandemic implications for the air travel sector, including video-conferencing as a substitute for air travel.
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Affiliation(s)
- Francesco Manca
- Urban Systems Lab, Centre for Transport Studies, Department of Civil and Environmental Engineering, Imperial College London, London SW7 2AZ, UK
| | - Jacek Pawlak
- Urban Systems Lab, Centre for Transport Studies, Department of Civil and Environmental Engineering, Imperial College London, London SW7 2AZ, UK
| | - Aruna Sivakumar
- Urban Systems Lab, Centre for Transport Studies, Department of Civil and Environmental Engineering, Imperial College London, London SW7 2AZ, UK
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35
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Devine T, Allport (Te Āti Awa) T, Walsh-Tapiata (Te Āti Haunui-a-Pāpārangi Ngā Rauru, Ngāti Ra W, Boulton (Ngāti Ranginui, Ngai Te Rangi, Ngāti Pukenga, Ngāti A. Equity, Public Health Messaging, and Traditional Māori Knowledge: The Te Ranga Tupua COVID-19 Response. JOURNAL OF HUMANISTIC PSYCHOLOGY 2022. [PMCID: PMC9780562 DOI: 10.1177/00221678221139013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Throughout the coronavirus disease 2019 (COVID-19) pandemic, the Māori, Indigenous people of New Zealand, public health response has been guided by the collaborative and relationship-centered principles of te ao Māori, the Māori world. This article presents the communications response to COVID-19 by Iwi, tribes, within Te Ranga Tupua (TRT), a collective of Iwi from the South Taranaki/Whanganui/Rangitīkei/Ruapehu regions of Aotearoa, New Zealand. This research uses a qualitative design based on a Kaupapa Māori approach. The research presented here focuses on the intersect between COVID-19-related public health messaging, and the application of Māori knowledge and worldviews to establish equitable protection for Māori. By prioritizing equity, self-determination, and adopting a holistic approach to well-being, TRT have been able to re-frame public health messaging in accordance with our tikanga, customs, and notions of Māori public health. We provide a snapshot of how a unique tribal collective deployed its resource to provide culturally appropriate information and communication responses to the first wave of COVID-19 in 2020, and then built on this knowledge and experience providing a modified and more strategic response to the pandemic in 2021.
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Affiliation(s)
- Tom Devine
- Whakauae Research Services Ltd, Whanganui, New Zealand
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Unwin HJT, Cori A, Imai N, Gaythorpe KAM, Bhatia S, Cattarino L, Donnelly CA, Ferguson NM, Baguelin M. Using next generation matrices to estimate the proportion of infections that are not detected in an outbreak. Epidemics 2022; 41:100637. [PMID: 36219929 DOI: 10.1016/j.epidem.2022.100637] [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: 03/01/2022] [Revised: 09/17/2022] [Accepted: 10/03/2022] [Indexed: 12/29/2022] Open
Abstract
Contact tracing, where exposed individuals are followed up to break ongoing transmission chains, is a key pillar of outbreak response for infectious disease outbreaks. Unfortunately, these systems are not fully effective, and infections can still go undetected as people may not remember all their contacts or contacts may not be traced successfully. A large proportion of undetected infections suggests poor contact tracing and surveillance systems, which could be a potential area of improvement for a disease response. In this paper, we present a method for estimating the proportion of infections that are not detected during an outbreak. Our method uses next generation matrices that are parameterized by linked contact tracing data and case line-lists. We validate the method using simulated data from an individual-based model and then investigate two case studies: the proportion of undetected infections in the SARS-CoV-2 outbreak in New Zealand during 2020 and the Ebola epidemic in Guinea during 2014. We estimate that only 5.26% of SARS-CoV-2 infections were not detected in New Zealand during 2020 (95% credible interval: 0.243 - 16.0%) if 80% of contacts were under active surveillance but depending on assumptions about the ratio of contacts not under active surveillance versus contacts under active surveillance 39.0% or 37.7% of Ebola infections were not detected in Guinea (95% credible intervals: 1.69 - 87.0% or 1.70 - 80.9%).
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Affiliation(s)
- H Juliette T Unwin
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, UK; The Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College London, UK.
| | - Anne Cori
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, UK; The Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College London, UK
| | - Natsuko Imai
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, UK; The Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College London, UK
| | - Katy A M Gaythorpe
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, UK; The Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College London, UK
| | - Sangeeta Bhatia
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, UK; The Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College London, UK
| | - Lorenzo Cattarino
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, UK; The Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College London, UK
| | - Christl A Donnelly
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, UK; The Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College London, UK; Department of Statistics, University of Oxford, UK
| | - Neil M Ferguson
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, UK; The Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College London, UK
| | - Marc Baguelin
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, UK; The Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College London, UK; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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Hammond V, Butchard M, Stablein H, Jack S. COVID-19 in one region of New Zealand: a descriptive epidemiological study. Aust N Z J Public Health 2022; 46:745-750. [PMID: 36190206 PMCID: PMC9874785 DOI: 10.1111/1753-6405.13305] [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: 11/01/2021] [Revised: 01/01/2022] [Accepted: 08/01/2022] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE To describe the epidemiology of COVID-19 in one region of New Zealand in the context of the national lockdown and provide a reference for comparing infection dynamics and control measures between SARS-Cov-2 strains. Methods: Epidemiological linking and analysis of COVID-19 cases and their close contacts residing in the geographical area served by the Southern District Health Board (SDHB). Results: From 13 March to 5 April 5 2020, 186 cases were laboratory-confirmed with wild-type Sars-Cov-2 in SDHB. Overall, 35·1% of cases were attributable to household transmission, 27·0% to non-household, 25·4% to overseas travel and 12·4% had no known epidemiological links. The highest secondary attack rate was observed in households during lockdown (15·3%, 95%CI 10·4-21·5). The mean serial interval in 50 exclusive infector-infectee pairs was 4·0 days (95%CI 3·2-4·7days), and the mean incubation period was 3.4 days (95%CI 2·7-4·2). CONCLUSIONS The SARS-CoV-2 incubation period may be shorter than early estimates that were limited by uncertainties in exposure history or small sample sizes. IMPLICATIONS FOR PUBLIC HEALTH The continuation of household transmission during lockdown highlights the need for effective home-based quarantine guidance. Our findings of a short incubation period highlight the need to contact trace and isolate as rapidly as possible.
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Affiliation(s)
- Vanessa Hammond
- Public Health South, Southern District Health Board, Dunedin, New Zealand,Correspondence to: Vanessa Hammond, Public Health South, Southern District Health Board, Private Bag 1921, Dunedin 9054, New Zealand
| | - Michael Butchard
- Public Health South, Southern District Health Board, Dunedin, New Zealand
| | - Hohepa Stablein
- Capital & Coast District Health Board, Wellington, New Zealand
| | - Susan Jack
- Public Health South, Southern District Health Board, Dunedin, New Zealand
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Gozzi N, Chinazzi M, Dean NE, Longini IM, Halloran ME, Perra N, Vespignani A. Estimating the impact of COVID-19 vaccine allocation inequities: a modeling study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.11.18.22282514. [PMID: 36415459 PMCID: PMC9681050 DOI: 10.1101/2022.11.18.22282514] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Access to COVID-19 vaccines on the global scale has been drastically impacted by structural socio-economic inequities. Here, we develop a data-driven, age-stratified epidemic model to evaluate the effects of COVID-19 vaccine inequities in twenty lower middle and low income countries (LMIC) sampled from all WHO regions. We focus on the first critical months of vaccine distribution and administration, exploring counterfactual scenarios where we assume the same per capita daily vaccination rate reported in selected high income countries. We estimate that, in this high vaccine availability scenario, more than 50% of deaths (min-max range: [56% - 99%]) that occurred in the analyzed countries could have been averted. We further consider a scenario where LMIC had similarly early access to vaccine doses as high income countries; even without increasing the number of doses, we estimate an important fraction of deaths (min-max range: [7% - 73%]) could have been averted. In the absence of equitable allocation, the model suggests that considerable additional non-pharmaceutical interventions would have been required to offset the lack of vaccines (min-max range: [15% - 75%]). Overall, our results quantify the negative impacts of vaccines inequities and call for amplified global efforts to provide better access to vaccine programs in low and lower middle income countries.
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39
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Carer distress among community living older adults with complex needs in the pre- and post-COVID-19 era: a national population study. Sci Rep 2022; 12:19697. [PMID: 36385630 PMCID: PMC9668208 DOI: 10.1038/s41598-022-24073-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 11/09/2022] [Indexed: 11/18/2022] Open
Abstract
Carer distress is one important negative impact of caregiving and likely exacerbated by the novel coronavirus disease 2019 (COVID-19) pandemic, yet little population-based epidemiological information exists. Using national data from repeated standardized comprehensive geriatric needs assessments, this study aims to: describe the pattern of caregiver distress among those providing informal care to community-living adults aged ≥ 65 years with complex needs in New Zealand over time; estimate the COVID-19 effect on this temporal pattern; and, investigate relationships between participants' sociodemographic and selected health measures on caregiver distress. Fractional polynomial regression and multivariable multilevel mixed-effects models were employed. Overall, 231,277 assessments from 144,358 participants were analysed. At first assessment, average age was 82.0 years (range 65-107 years), and 85,676 (59.4%) were female. Carer distress prevalence increased from 35.1% on 5 July 2012 to a peak of 48.5% on 21 March 2020, when the New Zealand Government announced a national lock-down. However, the population attributional fraction associated with the COVID-19 period was small, estimated at 0.56% (95% CI 0.35%, 0.77%). Carer distress is common and has rapidly increased in recent years. While significant, the COVID-19 impact has been relatively small. Policies and services providing efficacious on-going strategies to support caregivers deserves specific attention.
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De Vogli R. COVID-19 and the ecological crisis: What do they have in common? Scand J Public Health 2022:14034948221134339. [PMID: 36349518 PMCID: PMC9646884 DOI: 10.1177/14034948221134339] [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] [Indexed: 11/11/2022]
Abstract
This lecture transcript is divided in four parts. First, I examine the main
public-health strategies in managing the COVID-19 pandemic. Although there are
numerous factors capable of explaining national differences in COVID-19
mortality that are not attributable to merits or demerits of governments, I have
identified five lethal errors (lack of preparation, misinformation,
medicalisation, a policy approach based on a ‘laissez-faire’ attitude to the
virus and social inequity) and four vital actions (testing, tracing, isolating
with support, timeliness and immunisation) that best distinguish success or
failure in tackling the pandemic. In the second part, I analyse the origin of
SARS-CoV-2 and major risk factors for emerging zoonotic diseases (e.g.
exploitation of animal wildlife, deforestation, agricultural intensification and
climate change) to be addressed to prevent future pandemics. Then, I discuss the
interrelationships between the COVID-19 pandemic and the ecological crisis in
the context of the so-called neoliberal variant of capitalism. Both crises are
largely determined by anthropogenic risk factors influenced by a model of
economic development that prioritises infinite economic growth, free trade and a
global self-regulating market over any other values of society (including human
survival). An alternative economic approach, capable of creating a new balance
between the health of humans, animals, and the environment (by modifying their
structural drivers), is the most important antidote against
new spillovers and climate change. It is the humanitarian immune response we
need to protect global health from future pandemics and ecological collapse.
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Affiliation(s)
- Roberto De Vogli
- Department of Social Psychology and Development, University of Padova, Italy.,Department of Hygiene and Preventive Medicine, University of Bologna, Italy
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Filer J, Fleming T, Morris S, Upadhyay N, Landham P, Katsimihas M, Harding I. The effect of COVID-19 lockdown restrictions on oswestry disability index scores: a comparative cross-sectional study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2022; 31:2844-2850. [PMID: 36125614 PMCID: PMC9485790 DOI: 10.1007/s00586-022-07382-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 07/31/2022] [Accepted: 09/04/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE Lockdown measures to combat the COVID-19 pandemic restricted social interactions and travel. This retrospective, observational study was conducted to evaluate the effect of lockdown restrictions on Oswestry Disability Index (ODI) scores in patients with spinal conditions. METHODS Prospectively collected data from the British Spine Registry were retrospectively analysed in two groups. The study group included patients' baseline pre-operative ODI scores collected during the first national lockdown in the UK between March and May 2020. The reference group included ODI scores recorded during the same period in 2019, before the pandemic. Scores were compared between groups using the Mann-Whitney U test. We also calculated modified scores that omitted responses to questions related to travel and social life. These were compared using Wilcoxon matched-pairs signed-rank test and Bland-Altman analyses. RESULTS The median ODI scores for the reference and lockdown groups were 49 and 45, respectively, with no significant differences in the mean ranks (p = 0.068). Comparisons of original and modified ODI scores showed different outcomes for each study group. No significant differences were observed in the lockdown group (p = 0.06). However, for the pre-COVID-19 reference group, there was a significant difference (p < 0.01). Bland-Altman analyses showed reasonable agreement between the methods for calculating ODI in both groups. CONCLUSION We found no clinically important differences in ODI scores between the two groups. The findings suggest that the ODI is reliable during lockdown situations and can be used with confidence in the future research using both retrospective and prospective data. LEVEL OF EVIDENCE Level 3.
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Affiliation(s)
- Joshua Filer
- Musculoskeletal Directorate, North Bristol NHS Trust, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK
| | - Thomas Fleming
- Musculoskeletal Directorate, North Bristol NHS Trust, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK
| | - Stephen Morris
- Musculoskeletal Directorate, North Bristol NHS Trust, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK
| | - Neil Upadhyay
- Musculoskeletal Directorate, North Bristol NHS Trust, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK
| | - Priyan Landham
- Musculoskeletal Directorate, North Bristol NHS Trust, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK
| | - Michael Katsimihas
- Musculoskeletal Directorate, North Bristol NHS Trust, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK
| | - Ian Harding
- Musculoskeletal Directorate, North Bristol NHS Trust, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK.
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Zhu YJ, Tang K, Zhao FJ, Yu BY, Liu TT, Zhang LL. Impact of Social Deprivation on Hospitalization and Intensive Care Unit Admission among COVID-19 Patients: A Systematic Review and Meta-Analysis. IRANIAN JOURNAL OF PUBLIC HEALTH 2022; 51:2458-2471. [PMID: 36561272 PMCID: PMC9745414 DOI: 10.18502/ijph.v51i11.11163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 08/17/2022] [Indexed: 11/21/2022]
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected socially disadvantaged groups; however, the association between socioeconomic status and healthcare utilization among COVID-19 patients remains unclear. Therefore, a systematic review and meta-analysis was conducted to assess the association between socioeconomic status and hospitalization and intensive care unit admission among COVID-19 patients. Methods PubMed, Embase, and the Cochrane Register of Controlled Trials were searched for relevant literature (updated to Jun 2022). Studies that investigated the association of social deprivation with hospitalization and intensive care unit admission in COVID-19 patients were included. The primary outcomes included risk of hospitalization and intensive care unit admission, measured by odds ratio. Results Eleven studies covering 2,423,095 patients were included in the meta-analysis. Socially disadvantaged patients had higher odds of hospitalization in comparison to socially advantaged patients (odds ratio 1.25, 95% confidence interval: 1.14 to 1.38; P<0.01). The odds of intensive care unit admission among more deprived patients was not significantly different from that of less deprived patients (odds ratio 1.03, 95% confidence interval: 0.78 to 1.35; P=0.85). These findings were proven robust through subgroup and sensitivity analyses. Conclusion Socially disadvantaged populations have higher odds of hospitalization if they become infected with COVID-19. More effective medical support and interventions for these vulnerable populations are required to reduce inequity in healthcare utilization and alleviate the burden on healthcare systems.
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Affiliation(s)
- Yang-Jie Zhu
- Department of Military Health Management, College of Health Service, Naval Medical University, Shanghai 200433, China
| | - Kang Tang
- Department of Military Health Management, College of Health Service, Naval Medical University, Shanghai 200433, China
| | - Fang-Jie Zhao
- Department of Military Health Management, College of Health Service, Naval Medical University, Shanghai 200433, China
| | - Bo-Yang Yu
- Department of Military Health Management, College of Health Service, Naval Medical University, Shanghai 200433, China, Department of Medical Health Service, General Hospital of Northern Theater Command of PLA, Shenyang 110016, China
| | - Tong-Tong Liu
- Department of Military Health Management, College of Health Service, Naval Medical University, Shanghai 200433, China, Department of Medical Health Service, 969th Hospital of PLA Joint Logistics Support Forces, Hohhot 010051, China
| | - Lu-Lu Zhang
- Department of Military Health Management, College of Health Service, Naval Medical University, Shanghai 200433, China,Corresponding Author:
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Douglas J, Winter D, McNeill A, Carr S, Bunce M, French N, Hadfield J, de Ligt J, Welch D, Geoghegan JL. Tracing the international arrivals of SARS-CoV-2 Omicron variants after Aotearoa New Zealand reopened its border. Nat Commun 2022; 13:6484. [PMID: 36309507 PMCID: PMC9617600 DOI: 10.1038/s41467-022-34186-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 10/18/2022] [Indexed: 12/25/2022] Open
Abstract
In the second quarter of 2022, there was a global surge of emergent SARS-CoV-2 lineages that had a distinct growth advantage over then-dominant Omicron BA.1 and BA.2 lineages. By generating 10,403 Omicron genomes, we show that Aotearoa New Zealand observed an influx of these immune-evasive variants (BA.2.12.1, BA.4, and BA.5) through the border. This is explained by the return to significant levels of international travel following the border's reopening in March 2022. We estimate one Omicron transmission event from the border to the community for every ~5,000 passenger arrivals at the current levels of travel and restriction. Although most of these introductions did not instigate any detected onward transmission, a small minority triggered large outbreaks. Genomic surveillance at the border provides a lens on the rate at which new variants might gain a foothold and trigger new waves of infection.
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Affiliation(s)
- Jordan Douglas
- grid.9654.e0000 0004 0372 3343Centre for Computational Evolution,School of Computer Science, University of Auckland, Auckland, New Zealand
| | - David Winter
- grid.419706.d0000 0001 2234 622XInstitute of Environmental Science and Research, Wellington, New Zealand
| | - Andrea McNeill
- grid.419706.d0000 0001 2234 622XInstitute of Environmental Science and Research, Wellington, New Zealand
| | - Sam Carr
- grid.419706.d0000 0001 2234 622XInstitute of Environmental Science and Research, Wellington, New Zealand
| | - Michael Bunce
- grid.419706.d0000 0001 2234 622XInstitute of Environmental Science and Research, Wellington, New Zealand
| | - Nigel French
- grid.148374.d0000 0001 0696 9806Tāwharau Ora/School of Veterinary Science, Massey University, Palmerston North, New Zealand ,grid.419706.d0000 0001 2234 622XTe Niwha, Infectious Diseases Research Platform, Institute of Environmental Science and Research, Palmerston North, New Zealand
| | - James Hadfield
- grid.270240.30000 0001 2180 1622Fred Hutchinson Cancer Research Centre, Seattle, WA USA
| | - Joep de Ligt
- grid.419706.d0000 0001 2234 622XInstitute of Environmental Science and Research, Wellington, New Zealand
| | - David Welch
- grid.9654.e0000 0004 0372 3343Centre for Computational Evolution,School of Computer Science, University of Auckland, Auckland, New Zealand
| | - Jemma L. Geoghegan
- grid.419706.d0000 0001 2234 622XInstitute of Environmental Science and Research, Wellington, New Zealand ,grid.29980.3a0000 0004 1936 7830Department of Microbiology and Immunology, University of Otago, Dunedin, New Zealand
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Wild CEK, Wells H, Coetzee N, Grant CC, Sullivan TA, Derraik JGB, Anderson YC. Learning from healthcare workers' experiences with personal protective equipment during the COVID-19 pandemic in Aotearoa/New Zealand: a thematic analysis and framework for future practice. BMJ Open 2022; 12:e061413. [PMID: 36241354 PMCID: PMC9577277 DOI: 10.1136/bmjopen-2022-061413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Safety and welfare are critical as pandemic-related demands on the healthcare workforce continue. Access to personal protective equipment (PPE) has been a central concern of healthcare workers throughout the COVID-19 pandemic. Against the backdrop of an already strained healthcare system, our study aimed to explore the experiences of healthcare workers with PPE during the first COVID-19 surge (February-June 2020) in Aotearoa/New Zealand (NZ). We also aimed to use these findings to present a strengths-based framework for supporting healthcare workers moving forward. DESIGN Web-based, anonymous survey including qualitative open-text questions. Questions were both closed and open text, and recruitment was multimodal. We undertook inductive thematic analysis of the dataset as a whole to explore prominent values related to healthcare workers' experiences. SETTING October-November 2020 in New Zealand. PARTICIPANTS 1411 healthcare workers who used PPE during surge one of the COVID-19 pandemic. RESULTS We identified four interactive values as central to healthcare workers' experiences: transparency, trust, safety and respect. When healthcare workers cited positive experiences, trust and safety were perceived as present, with a sense of inclusion in the process of stock allocation and effective communication with managers. When trust was low, with concerns over personal safety, poor communication and lack of transparency resulted in perceived lack of respect and distress among respondents. Our proposed framework presents key recommendations to support the health workforce in terms of communication relating to PPE supply and distribution built on those four values. CONCLUSIONS Healthcare worker experiences with PPE access has been likened to 'the canary in the coalmine' for existing health system challenges that have been exacerbated during the COVID-19 pandemic. The four key values identified could be used to improve healthcare worker experience in the future.
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Affiliation(s)
- Cervantée E K Wild
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Hailey Wells
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Nicolene Coetzee
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Cameron C Grant
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- Department of General Paediatrics, Starship Children's Health, Auckland, New Zealand
| | - Trudy A Sullivan
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - José G B Derraik
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Yvonne C Anderson
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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Global Excess Mortality during COVID-19 Pandemic: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2022; 10:vaccines10101702. [PMID: 36298567 PMCID: PMC9607451 DOI: 10.3390/vaccines10101702] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 09/29/2022] [Accepted: 10/10/2022] [Indexed: 11/19/2022] Open
Abstract
Background: Currently, reported COVID-19 deaths are inadequate to assess the impact of the pandemic on global excess mortality. All-cause excess mortality is a WHO-recommended index for assessing the death burden of COVID-19. However, the global excess mortality assessed by this index remains unclear. We aimed to assess the global excess mortality during the COVID-19 pandemic. Methods: We searched PubMed, EMBASE, and Web of Science for studies published in English between 1 January 2020, and 21 May 2022. Cross-sectional and cohort studies that reported data about excess mortality during the pandemic were included. Two researchers independently searched the published studies, extracted data, and assessed quality. The Mantel–Haenszel random-effects method was adopted to estimate pooled risk difference (RD) and their 95% confidence intervals (CIs). Results: A total of 79 countries from twenty studies were included. During the COVID-19 pandemic, of 2,228,109,318 individuals, 17,974,051 all-cause deaths were reported, and 15,498,145 deaths were expected. The pooled global excess mortality was 104.84 (95% CI 85.56–124.13) per 100,000. South America had the highest pooled excess mortality [134.02 (95% CI: 68.24–199.80) per 100,000], while Oceania had the lowest [−32.15 (95% CI: −60.53–−3.77) per 100,000]. Developing countries had higher excess mortality [135.80 (95% CI: 107.83–163.76) per 100,000] than developed countries [68.08 (95% CI: 42.61–93.55) per 100,000]. Lower middle-income countries [133.45 (95% CI: 75.10–191.81) per 100,000] and upper-middle-income countries [149.88 (110.35–189.38) per 100,000] had higher excess mortality than high-income countries [75.54 (95% CI: 53.44–97.64) per 100,000]. Males had higher excess mortality [130.10 (95% CI: 94.15–166.05) per 100,000] than females [102.16 (95% CI: 85.76–118.56) per 100,000]. The population aged ≥ 60 years had the highest excess mortality [781.74 (95% CI: 626.24–937.24) per 100,000]. Conclusions: The pooled global excess mortality was 104.84 deaths per 100,000, and the number of reported all-cause deaths was higher than expected deaths during the global COVID-19 pandemic. In South America, developing and middle-income countries, male populations, and individuals aged ≥ 60 years had a heavier excess mortality burden.
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Banholzer N, Lison A, Özcelik D, Stadler T, Feuerriegel S, Vach W. The methodologies to assess the effectiveness of non-pharmaceutical interventions during COVID-19: a systematic review. Eur J Epidemiol 2022; 37:1003-1024. [PMID: 36152133 PMCID: PMC9510554 DOI: 10.1007/s10654-022-00908-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/15/2022] [Indexed: 11/26/2022]
Abstract
Non-pharmaceutical interventions, such as school closures and stay-at-home orders, have been implemented around the world to control the spread of SARS-CoV-2. Their effectiveness in improving health-related outcomes has been the subject of numerous empirical studies. However, these studies show fairly large variation among methodologies in use, reflecting the absence of an established methodological framework. On the one hand, variation in methodologies may be desirable to assess the robustness of results; on the other hand, a lack of common standards can impede comparability among studies. To establish a comprehensive overview over the methodologies in use, we conducted a systematic review of studies assessing the effectiveness of non-pharmaceutical interventions between January 1, 2020 and January 12, 2021 (n = 248). We identified substantial variation in methodologies with respect to study setting, outcome, intervention, methodological approach, and effectiveness assessment. On this basis, we point to shortcomings of existing studies and make recommendations for the design of future studies.
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Affiliation(s)
- Nicolas Banholzer
- Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland.
| | - Adrian Lison
- Department of Biosystems Science and Engineering, ETH Zurich, Zurich, Switzerland.
| | - Dennis Özcelik
- Chemistry | Biology | Pharmacy Information Center, ETH Zurich, Zurich, Switzerland
| | - Tanja Stadler
- Department of Biosystems Science and Engineering, ETH Zurich, Zurich, Switzerland
| | - Stefan Feuerriegel
- Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
- LMU Munich School of Management, LMU Munich, Munich, Germany
| | - Werner Vach
- Basel Academy for Quality and Research in Medicine, Basel, Switzerland
- Department of Environmental Sciences, University of Basel, Basel, Switzerland
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Cassim S, Keelan TJ. A review of localised Māori community responses to Covid-19 lockdowns in Aotearoa New Zealand. ALTERNATIVE: AN INTERNATIONAL JOURNAL OF INDIGENOUS PEOPLES 2022; 19:42-50. [PMID: 36967812 PMCID: PMC10028440 DOI: 10.1177/11771801221124428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aotearoa New Zealand has been commended for the overarching effectiveness of its Covid-19 response. Yet, the lockdowns challenged the health of whānau Māori (Māori families) alongside their social, cultural and financial well-being. However, Māori have repeatedly demonstrated innovative means of resilience throughout the pandemic. This review aimed to document the local grassroots, community-level responses to Covid-19 lockdowns by Māori. Three sources for searching for evidence were used: academic, websites and media, and Māori community networks. A total of 18 records were reviewed. Four of these records comprised published academic literature, 13 comprised news, online and media articles, and one was a situation report. Findings were grouped into three categories: distributive networks, well-being and resource support. The findings of this review provide an exemplar for the strength of Māori leadership and agency, alongside value-driven holistic approaches to health and well-being that could positively impact the health of all.
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Affiliation(s)
- Shemana Cassim
- Te Ngira: Institute for Population Research, Division of Arts, Law, Psychology & Social Science, University of Waikato, New Zealand
- Te Kura Hinengaro Tangata School of Psychology, Massey University, New Zealand
| | - Teorongonui Josie Keelan
- Ngā Pae o te Māramatanga, New Zealand’s Māori Centre of Research Excellence, Waipapa Taumata Rau, University of Auckland, New Zealand
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Hanney SR, Straus SE, Holmes BJ. Saving millions of lives but some resources squandered: emerging lessons from health research system pandemic achievements and challenges. Health Res Policy Syst 2022; 20:99. [PMID: 36088365 PMCID: PMC9464102 DOI: 10.1186/s12961-022-00883-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 06/27/2022] [Indexed: 12/15/2022] Open
Abstract
During the SARS-CoV-2 pandemic, astonishingly rapid research averted millions of deaths worldwide through new vaccines and repurposed and new drugs. Evidence use informed life-saving national policies including non-pharmaceutical interventions. Simultaneously, there was unprecedented waste, with many underpowered trials on the same drugs. We identified lessons from COVID-19 research responses by applying WHO's framework for research systems. It has four functions-governance, securing finance, capacity-building, and production and use of research-and nine components. Two linked questions focused the analysis. First, to what extent have achievements in knowledge production and evidence use built on existing structures and capacity in national health research systems? Second, did the features of such systems mitigate waste? We collated evidence on seven countries, Australia, Brazil, Canada, Germany, New Zealand, the United Kingdom and the United States, to identify examples of achievements and challenges.We used the data to develop lessons for each framework component. Research coordination, prioritization and expedited ethics approval contributed to rapid identification of new therapies, including dexamethasone in the United Kingdom and Brazil. Accelerated vaccines depended on extensive funding, especially through the Operation Warp Speed initiative in the United States, and new platforms created through long-term biomedical research capacity in the United Kingdom and, for messenger ribonucleic acid (mRNA) vaccines, in Canada, Germany and the United States. Research capacity embedded in the United Kingdom's healthcare system resulted in trial acceleration and waste avoidance. Faster publication of research saved lives, but raised challenges. Public/private collaborations made major contributions to vastly accelerating new products, available worldwide, though unequally. Effective developments of living (i.e. regularly updated) reviews and guidelines, especially in Australia and Canada, extended existing expertise in meeting users' needs. Despite complexities, effective national policy responses (less evident in Brazil, the United Kingdom and the United States) also saved lives by drawing on health research system features, including collaboration among politicians, civil servants and researchers; good communications; and willingness to use evidence. Comprehensive health research strategies contributed to success in research production in the United Kingdom and in evidence use by political leadership in New Zealand. In addition to waste, challenges included equity issues, public involvement and non-COVID research. We developed recommendations, but advocate studies of further countries.
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Affiliation(s)
- Stephen R Hanney
- Health Economics Research Group, Department of Health Sciences, Brunel University London, London, United Kingdom.
| | - Sharon E Straus
- St Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Bev J Holmes
- Michael Smith Health Research BC, Vancouver, BC, Canada
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Liu LS, Ran GJ, Jia X. New Zealand border restrictions amidst COVID-19 and their impacts on temporary migrant workers. ASIAN AND PACIFIC MIGRATION JOURNAL 2022; 31:312-323. [PMID: 38603233 PMCID: PMC9490383 DOI: 10.1177/01171968221126206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In September 2021, Immigration New Zealand (INZ) announced the offer of a one-off residence visa category - the 2021 Resident Visa, to over 165,000 temporary migrant workers and their family members living in the country. The offer was a response to the backlog and growing numbers of applications that INZ was unable to attend to largely because of the lockdown during the COVID-19 pandemic. Drawing on relevant statistical data, news media reports and available academic publications, this research note examines how New Zealand's sanitization policies during the pandemic affected the lives of temporary migrant workers who hold various work visas.
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The Effect of Strict Lockdown on Omicron SARS-CoV-2 Variant Transmission in Shanghai. Vaccines (Basel) 2022; 10:vaccines10091392. [PMID: 36146469 PMCID: PMC9500677 DOI: 10.3390/vaccines10091392] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/10/2022] [Accepted: 08/16/2022] [Indexed: 11/17/2022] Open
Abstract
Omicron, the current SARS-CoV-2 variant of concern, is much more contagious than other previous variants. Whether strict lockdown could effectively curb the transmission of Omicron is largely unknown. In this retrospective study, we compared the strictness of government lockdown policies in Shanghai and other countries. Based on the daily Omicron case number from 1 March 2022 to 30 April 2022, the effective reproductive numbers in this Shanghai Omicron wave were calculated to confirm the impact of strict lockdown on Omicron transmission. Pearson correlation was conducted to illustrate the determining factor of strict lockdown outcomes in the 16 different districts of Shanghai. After a very strict citywide lockdown since April 1st, the average daily effective reproductive number reduced significantly, indicating that strict lockdown could slow down the spreading of Omicron. Omicron control is more challenging in districts with higher population mobility and lockdown is more likely to decrease the number of asymptomatic carriers than the symptomatic cases. All these findings indicate that the strict lockdown could curb the transmission of Omicron effectively, especially for the asymptomatic spread, and suggest that differentiated COVID-19 prevention and control measures should be adopted according to the population density and demographic composition of each community.
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