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He X, Chen H, Zhu X, Gao W. Non-pharmaceutical interventions in containing COVID-19 pandemic after the roll-out of coronavirus vaccines: a systematic review. BMC Public Health 2024; 24:1524. [PMID: 38844867 PMCID: PMC11157849 DOI: 10.1186/s12889-024-18980-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 05/28/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Non-pharmaceutical interventions (NPIs) have been widely utilised to control the COVID-19 pandemic. However, it is unclear what the optimal strategies are for implementing NPIs in the context of coronavirus vaccines. This study aims to systematically identify, describe, and evaluate existing ecological studies on the real-world impact of NPIs in containing COVID-19 pandemic following the roll-out of coronavirus vaccines. METHODS We conducted a comprehensive search of relevant studies from January 1, 2021, to June 4, 2023 in PubMed, Embase, Web of science and MedRxiv. Two authors independently assessed the eligibility of the studies and extracted the data. A risk of bias assessment tool, derived from a bibliometric review of ecological studies, was applied to evaluate the study design, statistical methodology, and the quality of reporting. Data were collected, synthesised and analysed using qualitative and quantitative methods. The results were presented using summary tables and figures, including information on the target countries and regions of the studies, types of NPIs, and the quality of evidence. RESULTS The review included a total of 17 studies that examined the real-world impact of NPIs in containing the COVID-19 pandemic after the vaccine roll-out. These studies used five composite indicators that combined multiple NPIs, and examined 14 individual NPIs. The studies had an average quality assessment score of 13 (range: 10-16), indicating moderately high quality. NPIs had a larger impact than vaccination in mitigating the spread of COVID-19 during the early stage of the vaccination implementation and in the context of the Omicron variant. Testing policies, workplace closures, and restrictions on gatherings were the most effective NPIs in containing the COVID-19 pandemic, following the roll-out of vaccines. The impact of NPIs varied across different time frames, countries and regions. CONCLUSION NPIs had a larger contribution to the control of the pandemic as compared to vaccination during the early stage of vaccine implementation and in the context of the omicron variant. The impact of NPIs in containing the COVID-19 pandemic exhibited variability in diverse contexts. Policy- and decision-makers need to focus on the impact of different NPIs in diverse contexts. Further research is needed to understand the policy mechanisms and address potential future challenges.
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Affiliation(s)
- Xiaona He
- Department of Epidemiology and Health Statistics, School of Public Health, Jiangxi Medical College, Nanchang University, Nanchang, China
- Jiangxi Provincial Key Laboratory of Preventive Medicine and Public Health, Nanchang University, No. 461, Bayi Ave,, Nanchang, 330006, PR China
| | - Huiting Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Jiangxi Medical College, Nanchang University, Nanchang, China
- Jiangxi Provincial Key Laboratory of Preventive Medicine and Public Health, Nanchang University, No. 461, Bayi Ave,, Nanchang, 330006, PR China
| | - Xinyu Zhu
- Department of Epidemiology and Health Statistics, School of Public Health, Jiangxi Medical College, Nanchang University, Nanchang, China
- Jiangxi Provincial Key Laboratory of Preventive Medicine and Public Health, Nanchang University, No. 461, Bayi Ave,, Nanchang, 330006, PR China
| | - Wei Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Jiangxi Medical College, Nanchang University, Nanchang, China.
- Jiangxi Provincial Key Laboratory of Preventive Medicine and Public Health, Nanchang University, No. 461, Bayi Ave,, Nanchang, 330006, PR China.
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McClymont H, Hu W. The effect of public health interventions on COVID-19 incidence in Queensland, Australia: a spatial cluster analysis. Infect Dis (Lond) 2024; 56:460-475. [PMID: 38446488 DOI: 10.1080/23744235.2024.2324355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 02/23/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Using SaTScan™ Geographical Information Systems (GIS), spatial cluster analysis was used to examine spatial trends and identify high-risk clusters of Coronavirus 2019 (COVID-19) incidence in response to changing levels of public health intervention phases including international and state border closures, statewide vaccination coverage, and masking requirements. METHODS Changes in COVID-19 incidence were mapped at the statistical area 2 (SA2) level using a GIS and spatial cluster analysis was performed using SaTScan™ to identify most-likely clusters (MLCs) during intervention phases. RESULTS Over the study period, significant high-risk clusters were identified in Brisbane city (relative risk = 30.83), the southeast region (RR = 1.71) and moving to Far North Queensland (FNQ) (RR = 2.64). For masking levels, cluster locations were similar, with MLC in phase 1 in the southeast region (RR = 2.56) spreading to FNQ in phase 2 (RR = 2.22) and phase 3 (RR = 2.64). All p values <.0001. CONCLUSIONS Movement restrictions in the form of state and international border closures were highly effective in delaying the introduction of COVID-19 into Queensland, with very low levels of transmission prior to border reopening while mandatory masking may have played a role in decreasing transmission through behavioural changes. Early clusters were in highly populated regions, as restrictions eased clusters were identified in regions more likely to be rural or remote, with higher numbers of Indigenous people, lower vaccination coverage or lower socioeconomic status.
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Affiliation(s)
- Hannah McClymont
- School of Public Health and Social Work, Ecosystem Change, Population Health and Early Warning (ECAPH) Research Group, Queensland University of Technology (QUT), Brisbane, Australia
| | - Wenbiao Hu
- School of Public Health and Social Work, Ecosystem Change, Population Health and Early Warning (ECAPH) Research Group, Queensland University of Technology (QUT), Brisbane, Australia
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Waseel F, Streftaris G, Rudrusamy B, Dass SC. Assessing the dynamics and impact of COVID-19 vaccination on disease spread: A data-driven approach. Infect Dis Model 2024; 9:527-556. [PMID: 38525308 PMCID: PMC10958481 DOI: 10.1016/j.idm.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 02/23/2024] [Accepted: 02/23/2024] [Indexed: 03/26/2024] Open
Abstract
The COVID-19 pandemic has significantly impacted global health, social, and economic situations since its emergence in December 2019. The primary focus of this study is to propose a distinct vaccination policy and assess its impact on controlling COVID-19 transmission in Malaysia using a Bayesian data-driven approach, concentrating on the year 2021. We employ a compartmental Susceptible-Exposed-Infected-Recovered-Vaccinated (SEIRV) model, incorporating a time-varying transmission rate and a data-driven method for its estimation through an Exploratory Data Analysis (EDA) approach. While no vaccine guarantees total immunity against the disease, and vaccine immunity wanes over time, it is critical to include and accurately estimate vaccine efficacy, as well as a constant vaccine immunity decay or wane factor, to better simulate the dynamics of vaccine-induced protection over time. Based on the distribution and effectiveness of vaccines, we integrated a data-driven estimation of vaccine efficacy, calculated at 75% for Malaysia, underscoring the model's realism and relevance to the specific context of the country. The Bayesian inference framework is used to assimilate various data sources and account for underlying uncertainties in model parameters. The model is fitted to real-world data from Malaysia to analyze disease spread trends and evaluate the effectiveness of our proposed vaccination policy. Our findings reveal that this distinct vaccination policy, which emphasizes an accelerated vaccination rate during the initial stages of the program, is highly effective in mitigating the spread of COVID-19 and substantially reducing the pandemic peak and new infections. The study found that vaccinating 57-66% of the population (as opposed to 76% in the real data) with a better vaccination policy such as proposed here is able to significantly reduce the number of new infections and ultimately reduce the costs associated with new infections. The study contributes to the development of a robust and informative representation of COVID-19 transmission and vaccination, offering valuable insights for policymakers on the potential benefits and limitations of different vaccination policies, particularly highlighting the importance of a well-planned and efficient vaccination rollout strategy. While the methodology used in this study is specifically applied to national data from Malaysia, its successful application to local regions within Malaysia, such as Selangor and Johor, indicates its adaptability and potential for broader application. This demonstrates the model's adaptability for policy assessment and improvement across various demographic and epidemiological landscapes, implying its usefulness for similar datasets from various geographical regions.
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Affiliation(s)
- Farhad Waseel
- School of Mathematical and Computer Sciences, Heriot-Watt University Malaysia, Putrajaya, Malaysia
- Faculty of Mathematics, Kabul University, Kabul, Afghanistan
| | - George Streftaris
- School of Mathematical and Computer Sciences, Heriot-Watt University, Edinburgh, United Kingdom
- Maxwell Institute for Mathematical Sciences, United Kingdom
| | - Bhuvendhraa Rudrusamy
- School of Engineering and Physical Sciences, Heriot-Watt University Malaysia, Putrajaya, Malaysia
| | - Sarat C. Dass
- School of Mathematical and Computer Sciences, Heriot-Watt University Malaysia, Putrajaya, Malaysia
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Liu H, Cai J, Zhou J, Xu X, Ajelli M, Yu H. Assessing the impact of interventions on the major Omicron BA.2 outbreak in spring 2022 in Shanghai. Infect Dis Model 2024; 9:519-526. [PMID: 38463154 PMCID: PMC10924171 DOI: 10.1016/j.idm.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 02/26/2024] [Accepted: 02/26/2024] [Indexed: 03/12/2024] Open
Abstract
Background Shanghai experienced a significant surge in Omicron BA.2 infections from March to June 2022. In addition to the standard interventions in place at that time, additional interventions were implemented in response to the outbreak. However, the impact of these interventions on BA.2 transmission remains unclear. Methods We systematically collected data on the daily number of newly reported infections during this wave and utilized a Bayesian approach to estimate the daily effective reproduction number. Data on public health responses were retrieved from the Oxford COVID-19 Government Response Tracker and served as a proxy for the interventions implemented during this outbreak. Using a log-linear regression model, we assessed the impact of these interventions on the reproduction number. Furthermore, we developed a mathematical model of BA.2 transmission. By combining the estimated effect of the interventions from the regression model and the transmission model, we estimated the number of infections and deaths averted by the implemented interventions. Results We found a negative association (-0.0069, 95% CI: 0.0096 to -0.0045) between the level of interventions and the number of infections. If interventions did not ramp up during the outbreak, we estimated that the number of infections and deaths would have increased by 22.6% (95% CI: 22.4-22.8%), leading to a total of 768,576 (95% CI: 768,021-769,107) infections and 722 (95% CI: 722-723) deaths. If no interventions were deployed during the outbreak, we estimated that the number of infections and deaths would have increased by 46.0% (95% CI: 45.8-46.2%), leading to a total of 915,099 (95% CI: 914,639-915,518) infections and 860 (95% CI: 860-861) deaths. Conclusion Our findings suggest that the interventions adopted during the Omicron BA.2 outbreak in spring 2022 in Shanghai were effective in reducing SARS-CoV-2 transmission and disease burden. Our findings emphasize the importance of non-pharmacological interventions in controlling quick surges of cases during epidemic outbreaks.
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Affiliation(s)
- Hengcong Liu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Jun Cai
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Jiaxin Zhou
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Xiangyanyu Xu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Marco Ajelli
- Laboratory for Computational Epidemiology and Public Health, Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, USA
| | - Hongjie Yu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
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Collin A, Hejblum BP, Vignals C, Lehot L, Thiébaut R, Moireau P, Prague M. Using a population-based Kalman estimator to model the COVID-19 epidemic in France: estimating associations between disease transmission and non-pharmaceutical interventions. Int J Biostat 2024; 20:13-41. [PMID: 36607837 DOI: 10.1515/ijb-2022-0087] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 11/08/2022] [Indexed: 01/07/2023]
Abstract
In response to the COVID-19 pandemic caused by SARS-CoV-2, governments have adopted a wide range of non-pharmaceutical interventions (NPI). These include stringent measures such as strict lockdowns, closing schools, bars and restaurants, curfews, and barrier gestures such as mask-wearing and social distancing. Deciphering the effectiveness of each NPI is critical to responding to future waves and outbreaks. To this end, we first develop a dynamic model of the French COVID-19 epidemics over a one-year period. We rely on a global extended Susceptible-Infectious-Recovered (SIR) mechanistic model of infection that includes a dynamic transmission rate over time. Multilevel data across French regions are integrated using random effects on the parameters of the mechanistic model, boosting statistical power by multiplying integrated observation series. We estimate the parameters using a new population-based statistical approach based on a Kalman filter, used for the first time in analysing real-world data. We then fit the estimated time-varying transmission rate using a regression model that depends on the NPIs while accounting for vaccination coverage, the occurrence of variants of concern (VoC), and seasonal weather conditions. We show that all NPIs considered have an independent significant association with transmission rates. In addition, we show a strong association between weather conditions that reduces transmission in summer, and we also estimate increased transmissibility of VoC.
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Affiliation(s)
- Annabelle Collin
- Inria, Inria Bordeaux - Sud-Ouest, Bordeaux INP, IMB UMR 5251, Université Bordeaux, Talence, France
| | - Boris P Hejblum
- Inria, Inria Bordeaux - Sud-Ouest, Talence, Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, SISTM Team, UMR 1219, F-33000 Bordeaux, France
- Vaccine Research Institute, F-94000 Créteil, France
| | - Carole Vignals
- Inria, Inria Bordeaux - Sud-Ouest, Talence, Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, SISTM Team, UMR 1219, F-33000 Bordeaux, France
- Vaccine Research Institute, F-94000 Créteil, France
- CHU Pellegrin, F-33000 Bordeaux, France
| | - Laurent Lehot
- Inria, Inria Bordeaux - Sud-Ouest, Talence, Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, SISTM Team, UMR 1219, F-33000 Bordeaux, France
- Vaccine Research Institute, F-94000 Créteil, France
| | - Rodolphe Thiébaut
- Inria, Inria Bordeaux - Sud-Ouest, Talence, Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, SISTM Team, UMR 1219, F-33000 Bordeaux, France
- Vaccine Research Institute, F-94000 Créteil, France
- CHU Pellegrin, F-33000 Bordeaux, France
| | - Philippe Moireau
- ISPED Inserm U1219 Bordeaux Population Health Bureau 23 146 rue Leo Saignat CS 61292 33076 Bordeaux Cedex, France
| | - Mélanie Prague
- Inria, Inria Saclay-Ile de France, France and LMS, CNRS UMR 7649, Ecole Polytechnique, Institut Polytechnique de Paris, Palaiseau, France
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Zhang L, Ren T, He H, Huang L, Huang R, Xu Y, Zhou L, Tan H, Chen J, Wu D, Yang H, Zhang H, Yu J, Du X, Dai Y, Pu Y, Li C, Wang X, Shi S, Sahakian BJ, Luo Q, Li F. Protective factors for children with autism spectrum disorder during COVID-19-related strict lockdowns: a Shanghai autism early developmental cohort study. Psychol Med 2024; 54:1102-1112. [PMID: 37997447 DOI: 10.1017/s0033291723002908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
BACKGROUND COVID-19 lockdowns increased the risk of mental health problems, especially for children with autism spectrum disorder (ASD). However, despite its importance, little is known about the protective factors for ASD children during the lockdowns. METHODS Based on the Shanghai Autism Early Developmental Cohort, 188 ASD children with two visits before and after the strict Omicron lockdown were included; 85 children were lockdown-free, while 52 and 51 children were under the longer and the shorter durations of strict lockdown, respectively. We tested the association of the lockdown group with the clinical improvement and also the modulation effects of parent/family-related factors on this association by linear regression/mixed-effect models. Within the social brain structures, we examined the voxel-wise interaction between the grey matter volume and the identified modulation effects. RESULTS Compared with the lockdown-free group, the ASD children experienced the longer duration of strict lockdown had less clinical improvement (β = 0.49, 95% confidence interval (CI) [0.19-0.79], p = 0.001) and this difference was greatest for social cognition (2.62 [0.94-4.30], p = 0.002). We found that this association was modulated by parental agreeableness in a protective way (-0.11 [-0.17 to -0.05], p = 0.002). This protective effect was enhanced in the ASD children with larger grey matter volumes in the brain's mentalizing network, including the temporal pole, the medial superior frontal gyrus, and the superior temporal gyrus. CONCLUSIONS This longitudinal neuroimaging cohort study identified that the parental agreeableness interacting with the ASD children's social brain development reduced the negative impact on clinical symptoms during the strict lockdown.
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Affiliation(s)
- Lingli Zhang
- Department of Developmental and Behavioral Pediatric and Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research and Ministry of Education-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tai Ren
- Department of Developmental and Behavioral Pediatric and Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research and Ministry of Education-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hua He
- Department of Developmental and Behavioral Pediatric and Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research and Ministry of Education-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Like Huang
- Department of Developmental and Behavioral Pediatric and Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research and Ministry of Education-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Runqi Huang
- Department of Developmental and Behavioral Pediatric and Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research and Ministry of Education-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yixiang Xu
- Department of Developmental and Behavioral Pediatric and Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research and Ministry of Education-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Zhou
- Psychology and Neuroscience of Cognition Research Unit, University of Liège, Liège, Belgium
| | - Hangyu Tan
- Department of Developmental and Behavioral Pediatric and Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research and Ministry of Education-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingyu Chen
- Department of Developmental and Behavioral Pediatric and Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research and Ministry of Education-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Danping Wu
- Department of Developmental and Behavioral Pediatric and Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research and Ministry of Education-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hanshu Yang
- Department of Developmental and Behavioral Pediatric and Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research and Ministry of Education-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haotian Zhang
- Department of Developmental and Behavioral Pediatric and Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research and Ministry of Education-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Juehua Yu
- Department of Developmental and Behavioral Pediatric and Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research and Ministry of Education-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Center for Experimental Studies and Research, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xiujuan Du
- Department of Developmental and Behavioral Pediatric and Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research and Ministry of Education-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuan Dai
- Department of Developmental and Behavioral Pediatric and Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research and Ministry of Education-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiwei Pu
- Department of Developmental and Behavioral Pediatric and Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research and Ministry of Education-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiang Wang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Shenxun Shi
- Psychiatry Department of Huashan Hospital, Fudan University, Shanghai, China
| | - Barbara J Sahakian
- Department of Developmental and Behavioral Pediatric and Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research and Ministry of Education-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Psychiatry and the Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Qiang Luo
- National Clinical Research Center for Aging and Medicine at Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai 200433, China
- MOE Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Institutes of Brain Science and Human Phenome Institute, Fudan University, Shanghai 200032, China
| | - Fei Li
- Department of Developmental and Behavioral Pediatric and Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research and Ministry of Education-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Wu G, Zhang W, Wu W, Wang P, Huang Z, Wu Y, Li J, Zhang W, Du Z, Hao Y. Revisiting the complex time-varying effect of non-pharmaceutical interventions on COVID-19 transmission in the United States. Front Public Health 2024; 12:1343950. [PMID: 38450145 PMCID: PMC10915018 DOI: 10.3389/fpubh.2024.1343950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 02/08/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction Although the global COVID-19 emergency ended, the real-world effects of multiple non-pharmaceutical interventions (NPIs) and the relative contribution of individual NPIs over time were poorly understood, limiting the mitigation of future potential epidemics. Methods Based on four large-scale datasets including epidemic parameters, virus variants, vaccines, and meteorological factors across 51 states in the United States from August 2020 to July 2022, we established a Bayesian hierarchical model with a spike-and-slab prior to assessing the time-varying effect of NPIs and vaccination on mitigating COVID-19 transmission and identifying important NPIs in the context of different variants pandemic. Results We found that (i) the empirical reduction in reproduction number attributable to integrated NPIs was 52.0% (95%CI: 44.4, 58.5%) by August and September 2020, whereas the reduction continuously decreased due to the relaxation of NPIs in following months; (ii) international travel restrictions, stay-at-home requirements, and restrictions on gathering size were important NPIs with the relative contribution higher than 12.5%; (iii) vaccination alone could not mitigate transmission when the fully vaccination coverage was less than 60%, but it could effectively synergize with NPIs; (iv) even with fully vaccination coverage >60%, combined use of NPIs and vaccination failed to reduce the reproduction number below 1 in many states by February 2022 because of elimination of above NPIs, following with a resurgence of COVID-19 after March 2022. Conclusion Our results suggest that NPIs and vaccination had a high synergy effect and eliminating NPIs should consider their relative effectiveness, vaccination coverage, and emerging variants.
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Affiliation(s)
- Gonghua Wu
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Wanfang Zhang
- Guangzhou Liwan District Center for Disease Prevention and Control, Guangzhou, China
| | - Wenjing Wu
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Pengyu Wang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Zitong Huang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Yueqian Wu
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Junxi Li
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Wangjian Zhang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Zhicheng Du
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
- Guangzhou Joint Research Center for Disease Surveillance and Risk Assessment, Sun Yat-sen University and Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Yuantao Hao
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing, China
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Yang LX, Lin CY, Zhan WZ, Chiang BA, Chang EC. Why Do We Not Wear Masks Anymore during the COVID-19 Wave? Vaccination Precludes the Adoption of Personal Non-Pharmaceutical Interventions: A Quantitative Study of Taiwanese Residents. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:301. [PMID: 38399588 PMCID: PMC10890679 DOI: 10.3390/medicina60020301] [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: 01/10/2024] [Revised: 02/02/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: This study examined whether the decline in people's adoption of personal NPIs (e.g., mask wearing) results from the preclusion by vaccination. This study also incorporates the concepts of risk perception and the risk-as-feelings model to elucidate the possible mechanisms behind this preclusion. Materials and Methods: Two cross-sectional surveys (N = 462 in Survey 1 and N = 505 in Survey 2) were administered before and during the first outbreak of COVID-19 in Taiwan. The survey items were designed to measure participants' perceived severity of COVID-19, worry about COVID-19, intention to adopt personal NPIs, and attitudes toward COVID-19 vaccines. Utilizing the risk perception framework, we conducted multigroup SEM (Structural Equation Modeling) to construct the optimal structural model for both samples. Results and Conclusions: The multigroup SEM results showed that worry (i.e., the emotional component of risk perception) fully mediates the influence of the perceived severity of COVID-19 (i.e., the cognitive component of risk perception) on the intention to adopt NPIs in both surveys [z = 4.03, p < 0.001 for Survey 1 and z = 2.49, p < 0.050 for Survey 2]. Before the outbreak (i.e., Survey 1), people's attitudes toward COVID-19 vaccines showed no significant association with their worry about COVID-19 [z = 0.66, p = 0.508]. However, in Survey 2, following the real outbreak of COVID-19, people's attitudes toward COVID-19 vaccines negatively predicts their worry about COVID-19 [z = -4.31, p < 0.001], indirectly resulting in a negative effect on their intention to adopt personal NPIs. This suggests the occurrence of the Peltzman effect. That is, vaccination fosters a sense of safety, subsequently diminishing alertness to COVID-19, and thus reducing the intention to adopt personal NPIs.
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Affiliation(s)
- Lee-Xieng Yang
- Department of Psychology, National Chengchi University, Taipei 11605, Taiwan; (W.-Z.Z.); (B.-A.C.); (E.-C.C.)
- Research Center for Mind, Brain, and Learning, National Chengchi University, Taipei 11605, Taiwan
| | - Chia-Yuan Lin
- Department of Psychology, University of Huddersfield, Huddersfield HD1 3DH, UK;
- Centre of Cognition and Neuroscience, University of Huddersfield, Huddersfield HD1 3DH, UK
| | - Wan-Zhen Zhan
- Department of Psychology, National Chengchi University, Taipei 11605, Taiwan; (W.-Z.Z.); (B.-A.C.); (E.-C.C.)
| | - Bo-An Chiang
- Department of Psychology, National Chengchi University, Taipei 11605, Taiwan; (W.-Z.Z.); (B.-A.C.); (E.-C.C.)
| | - En-Chi Chang
- Department of Psychology, National Chengchi University, Taipei 11605, Taiwan; (W.-Z.Z.); (B.-A.C.); (E.-C.C.)
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9
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Cao H, Cao L. Differentiating behavioral impact with or without vaccination certification under mass vaccination and non-pharmaceutical interventions on mitigating COVID-19. Sci Rep 2024; 14:707. [PMID: 38184669 PMCID: PMC10771507 DOI: 10.1038/s41598-023-50421-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 12/19/2023] [Indexed: 01/08/2024] Open
Abstract
As COVID-19 vaccines became widely available worldwide, many countries implemented vaccination certification, also known as a "green pass", to promote and expedite vaccination on containing virus spread from the latter half of 2021. This policy allowed those vaccinated to have more freedom in public activities compared to more constraints on the unvaccinated in addition to existing non-pharmaceutical interventions (NPIs). Accordingly, the vaccination certification also induced heterogeneous behaviors of unvaccinated and vaccinated groups. This makes it essential yet challenging to model the behavioral impact of vaccination certification on the two groups and the transmission dynamics of COVID-19 within and between the groups. Very limited quantitative work is available for addressing these purposes. Here we propose an extended epidemiological model SEIQRD[Formula: see text] to effectively distinguish the behavioral impact of vaccination certification on unvaccinated and vaccinated groups through incorporating two contrastive transmission chains. SEIQRD[Formula: see text] also quantifies the impact of the green pass policy. With the resurgence of COVID-19 in Greece, Austria, and Israel in 2021, our simulation results indicate that their implementation of vaccination certification brought about more than a 14-fold decrease in the total number of infections and deaths as compared to a scenario with no such a policy. Additionally, a green pass policy may offer a reasonable practical solution to strike the balance between public health and individual's freedom during the pandemic.
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Affiliation(s)
- Hu Cao
- School of Computing, Macquarie University, Sydney, NSW, 2109, Australia
| | - Longbing Cao
- School of Computing, Macquarie University, Sydney, NSW, 2109, Australia.
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10
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Sabbatini CE, Pullano G, Di Domenico L, Rubrichi S, Bansal S, Colizza V. The impact of spatial connectivity on NPIs effectiveness. BMC Infect Dis 2024; 24:21. [PMID: 38166649 PMCID: PMC10763474 DOI: 10.1186/s12879-023-08900-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 12/12/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND France implemented a combination of non-pharmaceutical interventions (NPIs) to manage the COVID-19 pandemic between September 2020 and June 2021. These included a lockdown in the fall 2020 - the second since the start of the pandemic - to counteract the second wave, followed by a long period of nighttime curfew, and by a third lockdown in the spring 2021 against the Alpha wave. Interventions have so far been evaluated in isolation, neglecting the spatial connectivity between regions through mobility that may impact NPI effectiveness. METHODS Focusing on September 2020-June 2021, we developed a regionally-based epidemic metapopulation model informed by observed mobility fluxes from daily mobile phone data and fitted the model to regional hospital admissions. The model integrated data on vaccination and variants spread. Scenarios were designed to assess the impact of the Alpha variant, characterized by increased transmissibility and risk of hospitalization, of the vaccination campaign and alternative policy decisions. RESULTS The spatial model better captured the heterogeneity observed in the regional dynamics, compared to models neglecting inter-regional mobility. The third lockdown was similarly effective to the second lockdown after discounting for immunity, Alpha, and seasonality (51% vs 52% median regional reduction in the reproductive number R0, respectively). The 6pm nighttime curfew with bars and restaurants closed, implemented in January 2021, substantially reduced COVID-19 transmission. It initially led to 49% median regional reduction of R0, decreasing to 43% reduction by March 2021. In absence of vaccination, implemented interventions would have been insufficient against the Alpha wave. Counterfactual scenarios proposing a sequence of lockdowns in a stop-and-go fashion would have reduced hospitalizations and restriction days for low enough thresholds triggering and lifting restrictions. CONCLUSIONS Spatial connectivity induced by mobility impacted the effectiveness of interventions especially in regions with higher mobility rates. Early evening curfew with gastronomy sector closed allowed authorities to delay the third wave. Stop-and-go lockdowns could have substantially lowered both healthcare and societal burdens if implemented early enough, compared to the observed application of lockdown-curfew-lockdown, but likely at the expense of several labor sectors. These findings contribute to characterize the effectiveness of implemented strategies and improve pandemic preparedness.
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Affiliation(s)
- Chiara E Sabbatini
- Sorbonne Université, INSERM, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Giulia Pullano
- Department of Biology, Georgetown University, Washington, DC, USA
| | - Laura Di Domenico
- Sorbonne Université, INSERM, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Stefania Rubrichi
- Orange Labs, Sociology and Economics of Networks and Services (SENSE), Chatillon, France
| | - Shweta Bansal
- Department of Biology, Georgetown University, Washington, DC, USA
| | - Vittoria Colizza
- Sorbonne Université, INSERM, Pierre Louis Institute of Epidemiology and Public Health, Paris, France.
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11
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Chapman LAC, Aubry M, Maset N, Russell TW, Knock ES, Lees JA, Mallet HP, Cao-Lormeau VM, Kucharski AJ. Impact of vaccinations, boosters and lockdowns on COVID-19 waves in French Polynesia. Nat Commun 2023; 14:7330. [PMID: 37957160 PMCID: PMC10643399 DOI: 10.1038/s41467-023-43002-x] [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: 03/29/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
Estimating the impact of vaccination and non-pharmaceutical interventions on COVID-19 incidence is complicated by several factors, including successive emergence of SARS-CoV-2 variants of concern and changing population immunity from vaccination and infection. We develop an age-structured multi-strain COVID-19 transmission model and inference framework to estimate vaccination and non-pharmaceutical intervention impact accounting for these factors. We apply this framework to COVID-19 waves in French Polynesia and estimate that the vaccination programme averted 34.8% (95% credible interval: 34.5-35.2%) of 223,000 symptomatic cases, 49.6% (48.7-50.5%) of 5830 hospitalisations and 64.2% (63.1-65.3%) of 1540 hospital deaths that would have occurred in a scenario without vaccination up to May 2022. We estimate the booster campaign contributed 4.5%, 1.9%, and 0.4% to overall reductions in cases, hospitalisations, and deaths. Our results suggest that removing lockdowns during the first two waves would have had non-linear effects on incidence by altering accumulation of population immunity. Our estimates of vaccination and booster impact differ from those for other countries due to differences in age structure, previous exposure levels and timing of variant introduction relative to vaccination, emphasising the importance of detailed analysis that accounts for these factors.
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Affiliation(s)
- Lloyd A C Chapman
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK.
- Department of Mathematics and Statistics, Lancaster University, Lancaster, UK.
| | - Maite Aubry
- Laboratoire de recherche sur les infections virales émergentes, Institut Louis Malardé, Tahiti, French Polynesia
| | - Noémie Maset
- Cellule Epi-surveillance Plateforme COVID-19, Tahiti, French Polynesia
| | - Timothy W Russell
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Edward S Knock
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
| | - John A Lees
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
- European Molecular Biology Laboratory, European Bioinformatics Institute EMBL-EBI, Cambridgeshire, UK
| | | | - Van-Mai Cao-Lormeau
- Laboratoire de recherche sur les infections virales émergentes, Institut Louis Malardé, Tahiti, French Polynesia
| | - Adam J Kucharski
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Laboratoire de recherche sur les infections virales émergentes, Institut Louis Malardé, Tahiti, French Polynesia
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12
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Walkowiak MP, Domaradzki J, Walkowiak D. Unmasking the COVID-19 pandemic prevention gains: excess mortality reversal in 2022. Public Health 2023; 223:193-201. [PMID: 37672832 DOI: 10.1016/j.puhe.2023.08.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 07/11/2023] [Accepted: 08/02/2023] [Indexed: 09/08/2023]
Abstract
OBJECTIVES The purpose of this study was to assess the long-term effectiveness of COVID-19 pandemic prevention measures in saving lives after European governments began to lift restrictions. STUDY DESIGN Excess mortality interrupted time series. METHODS Country-level weekly data on deaths were fitted to the Poisson mixed linear model to estimate excess deaths. Based on this estimate, the percentage of excess deaths above the baseline during the pandemic (week 11 in 2020 to week 15 in 2022) (when public health interventions were in place) and during the post-pandemic period (week 16 in 2022 to week 52 in 2022) were calculated. These results were fitted to the linear regression model to determine any potential relationship between mortality during these two periods. RESULTS The model used in this study had high predictive value (adjusted R2 = 59.4%). Mortality during the endemic (post-pandemic) period alone increased by 7.2% (95% confidence interval [CI]: 5.7, 8.6) above baseline, while each percentage increase in mortality during the pandemic corresponded to a 0.357% reduction (95% CI: 0.243, 0.471) in mortality during the post-pandemic period. CONCLUSIONS The most successful countries in terms of protective measures also experienced the highest mortality rates after restrictions were lifted. The model used in this study clearly shows a measure of bidirectional mortality displacement that is sufficiently clear to mask any impact of long COVID on overall mortality. Results from this study also seriously impact previous cost-benefit analyses of pandemic prevention measures, since, according to the current model, 12.2% (95% CI: 8.3, 16.1) of the gains achieved in pandemic containment were lost after restrictions were lifted.
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Affiliation(s)
- M P Walkowiak
- Department of Preventive Medicine, Poznan University of Medical Sciences, Poznań, Poland.
| | - J Domaradzki
- Department of Social Sciences and Humanities, Poznan University of Medical Sciences, Poznań, Poland.
| | - D Walkowiak
- Department of Organization and Management in Health Care, Poznan University of Medical Sciences, Poznań, Poland.
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13
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Glette-Iversen I, Aven T, Flage R. A risk science perspective on vaccines. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2023. [PMID: 37748932 DOI: 10.1111/risa.14228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 08/27/2023] [Accepted: 09/05/2023] [Indexed: 09/27/2023]
Abstract
Vaccines can be seen as one of the greatest successes in modern medicine. Good examples are the vaccines against smallpox, polio, and measles. Unfortunately, vaccines can have side effects, but the risks are considered by the health authorities and experts to be small compared to their benefits. Nevertheless, there are many who are skeptical of vaccination, something which has been very clearly demonstrated in relation to the COVID-19 disease. Risk is the key concept when evaluating a vaccine, in relation to both its ability to protect against the disease and its side effects. However, risk is a challenging concept to measure, which makes communication about vaccines' performance and side effects difficult. The present article aims at providing new insights into vaccine risks-the understanding, perception, communication, and handling of them-by adopting what is here referred to as a contemporary risk science perspective. This perspective clarifies the relationships between the risk concept and terms like uncertainty, knowledge, and probability. The skepticism toward vaccines is multifaceted, and influenced by concerns that extend beyond the effectiveness and safety of the vaccines. However, by clarifying the relationships between key concepts of risk, particularly how uncertainty affects risk and its characterization, we can improve our understanding of this issue.
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Affiliation(s)
- Ingrid Glette-Iversen
- Department of Safety, Economics and Planning, University of Stavanger, Stavanger, Norway
| | - Terje Aven
- Department of Safety, Economics and Planning, University of Stavanger, Stavanger, Norway
| | - Roger Flage
- Department of Safety, Economics and Planning, University of Stavanger, Stavanger, Norway
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14
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Silva TC, Anghinoni L, Chagas CPD, Zhao L, Tabak BM. Analysis of the Effectiveness of Public Health Measures on COVID-19 Transmission. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6758. [PMID: 37754616 PMCID: PMC10531329 DOI: 10.3390/ijerph20186758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/20/2023] [Accepted: 09/06/2023] [Indexed: 09/28/2023]
Abstract
In this study, we investigate the COVID-19 epidemics in Brazilian cities, using early-time approximations of the SIR model in networks and combining the VAR (vector autoregressive) model with machine learning techniques. Different from other works, the underlying network was constructed by inputting real-world data on local COVID-19 cases reported by Brazilian cities into a regularized VAR model. This model estimates directional COVID-19 transmission channels (connections or links between nodes) of each pair of cities (vertices or nodes) using spectral network analysis. Despite the simple epidemiological model, our predictions align well with the real COVID-19 dynamics across Brazilian municipalities, using data only up until May 2020. Given the rising number of infectious people in Brazil-a possible indicator of a second wave-these early-time approximations could be valuable in gauging the magnitude of the next contagion peak. We further examine the effect of public health policies, including social isolation and mask usage, by creating counterfactual scenarios to quantify the human impact of these public health measures in reducing peak COVID-19 cases. We discover that the effectiveness of social isolation and mask usage varies significantly across cities. We hope our study will support the development of future public health measures.
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Affiliation(s)
- Thiago Christiano Silva
- Universidade Católica de Brasília, Brasilia 71966-700, Brazil
- Department of Computing and Mathematics, Faculty of Philosophy, Sciences, and Literatures in Ribeirão Preto, Universidade de São Paulo, São Paulo 14040-901, Brazil
| | - Leandro Anghinoni
- Department of Computing and Mathematics, Faculty of Philosophy, Sciences, and Literatures in Ribeirão Preto, Universidade de São Paulo, São Paulo 14040-901, Brazil
| | | | - Liang Zhao
- Department of Computing and Mathematics, Faculty of Philosophy, Sciences, and Literatures in Ribeirão Preto, Universidade de São Paulo, São Paulo 14040-901, Brazil
| | - Benjamin Miranda Tabak
- FGV/EPPG Escola de Políticas Públicas e Governo, Fundação Getúlio Vargas (School of Public Policy and Government, Getulio Vargas Foundation), Brasilia 70830-020, Brazil
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15
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Walkowiak MP, Walkowiak D, Walkowiak J. To vaccinate or to isolate? Establishing which intervention leads to measurable mortality reduction during the COVID-19 Delta wave in Poland. Front Public Health 2023; 11:1221964. [PMID: 37744498 PMCID: PMC10513426 DOI: 10.3389/fpubh.2023.1221964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Background During the Delta variant COVID-19 wave in Poland there were serious regional differences in vaccination rates and discrepancies in the enforcement of pandemic preventive measures, which allowed us to assess the relative effectiveness of the policies implemented. Methods Creating a model that would predict mortality based on vaccination rates among the most vulnerable groups and the timing of the wave peak enabled us to calculate to what extent flattening the curve reduced mortality. Subsequently, a model was created to assess which preventive measures delayed the peak of infection waves. Combining those two models allowed us to estimate the relative effectiveness of those measures. Results Flattening the infection curve worked: according to our model, each week of postponing the peak of the wave reduced excess deaths by 1.79%. Saving a single life during the Delta wave required one of the following: either the vaccination of 57 high-risk people, or 1,258 low-risk people to build herd immunity, or the isolation of 334 infected individuals for a cumulative period of 10.1 years, or finally quarantining 782 contacts for a cumulative period of 19.3 years. Conclusions Except for the most disciplined societies, vaccination of high-risk individuals followed by vaccinating low-risk groups should have been the top priority instead of relying on isolation and quarantine measures which can incur disproportionately higher social costs. Our study demonstrates that even in a country with uniform policies, implementation outcomes varied, highlighting the importance of fine-tuning policies to regional specificity.
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Affiliation(s)
- Marcin Piotr Walkowiak
- Department of Preventive Medicine, Poznan University of Medical Sciences, Poznań, Poland
| | - Dariusz Walkowiak
- Department of Organization and Management in Health Care, Poznan University of Medical Sciences, Poznań, Poland
| | - Jarosław Walkowiak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznań, Poland
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16
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Svetina L, Košec A. Wearing masks to prevent one epidemic may mask another. J Infect Prev 2023; 24:228-231. [PMID: 37736126 PMCID: PMC10510661 DOI: 10.1177/17571774231191335] [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] [Accepted: 05/04/2023] [Indexed: 09/23/2023] Open
Abstract
Background With attempts at lifting most COVID-19 pandemic-related restrictions, other common respiratory viruses have caused more health concern than in earlier seasons in pediatric populations. Objective To explore the role of non-pharmaceutical interventions (NPIs) in a rebound in other respiratory viral pathogens, especially in light of general vaccination fatigue, COVID-19 boosters, and operational challenges in the healthcare system. Methods A research-based commentary supported with recent literature review. Findings Pandemic-related lockdowns in Europe, Australia, and New Zealand have created a significant population of susceptible young children without preexisting immunity due to lack of exposure during the colder months. Relying on NPIs for a prolonged period due to low vaccination rates may lead to increased respiratory infection susceptibility, especially among young children less than 5 years old. The key public health question is whether NPIs should be implemented in the long run and what are the long-term implications on the dynamics of endemic infections and population immunity. Discussion Prevention cannot be the only cure for any infectious disease, and long-term impact of NPIs depends on the dynamics of population susceptibility. The SARS-CoV-2 pandemic has reinforced the importance of vaccination and the knowledge on vaccine use combined with NPIs will be of great value in controlling other known and unknown respiratory pathogens. Combining NPIs and vaccination is paramount in disease control, and the discussion on how to prevent collateral damage to sensitive populations while relaxing NPI-related measures should also merit attention.
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Affiliation(s)
- Lucija Svetina
- School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Cardiac Surgery, University Hospital Center Zagreb, Zagreb, Croatia
| | - Andro Košec
- Department of Cardiac Surgery, University Hospital Center Zagreb, Zagreb, Croatia
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia
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17
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Ge Y, Wu X, Zhang W, Wang X, Zhang D, Wang J, Liu H, Ren Z, Ruktanonchai NW, Ruktanonchai CW, Cleary E, Yao Y, Wesolowski A, Cummings DAT, Li Z, Tatem AJ, Lai S. Effects of public-health measures for zeroing out different SARS-CoV-2 variants. Nat Commun 2023; 14:5270. [PMID: 37644012 PMCID: PMC10465600 DOI: 10.1038/s41467-023-40940-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 08/15/2023] [Indexed: 08/31/2023] Open
Abstract
Targeted public health interventions for an emerging epidemic are essential for preventing pandemics. During 2020-2022, China invested significant efforts in strict zero-COVID measures to contain outbreaks of varying scales caused by different SARS-CoV-2 variants. Based on a multi-year empirical dataset containing 131 outbreaks observed in China from April 2020 to May 2022 and simulated scenarios, we ranked the relative intervention effectiveness by their reduction in instantaneous reproduction number. We found that, overall, social distancing measures (38% reduction, 95% prediction interval 31-45%), face masks (30%, 17-42%) and close contact tracing (28%, 24-31%) were most effective. Contact tracing was crucial in containing outbreaks during the initial phases, while social distancing measures became increasingly prominent as the spread persisted. In addition, infections with higher transmissibility and a shorter latent period posed more challenges for these measures. Our findings provide quantitative evidence on the effects of public-health measures for zeroing out emerging contagions in different contexts.
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Affiliation(s)
- Yong Ge
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China.
- Key Laboratory of Poyang Lake Wetland and Watershed Research Ministry of Education, Jiangxi Normal University, Nanchang, China.
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, China.
| | - Xilin Wu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, China
| | - Wenbin Zhang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, China
- WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, UK
| | - Xiaoli Wang
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Die Zhang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
- Key Laboratory of Poyang Lake Wetland and Watershed Research Ministry of Education, Jiangxi Normal University, Nanchang, China
| | - Jianghao Wang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, China
| | - Haiyan Liu
- Marine Data Center, Southern Marine Science and Engineering Guangdong Laboratory (Zhuhai), Zhuhai, China
| | - Zhoupeng Ren
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
| | | | | | - Eimear Cleary
- WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, UK
| | - Yongcheng Yao
- WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, UK
- School of Mathematics and Statistics, Zhengzhou Normal University, Zhengzhou, China
| | - Amy Wesolowski
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Derek A T Cummings
- Department of Biology and Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Zhongjie Li
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Andrew J Tatem
- WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, UK
| | - Shengjie Lai
- WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, UK.
- Institute for Life Sciences, University of Southampton, Southampton, UK.
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China.
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18
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Ning X, Guan J, Li XA, Wei Y, Chen F. Physics-Informed Neural Networks Integrating Compartmental Model for Analyzing COVID-19 Transmission Dynamics. Viruses 2023; 15:1749. [PMID: 37632091 PMCID: PMC10459488 DOI: 10.3390/v15081749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/03/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
Modelling and predicting the behaviour of infectious diseases is essential for early warning and evaluating the most effective interventions to prevent significant harm. Compartmental models produce a system of ordinary differential equations (ODEs) that are renowned for simulating the transmission dynamics of infectious diseases. However, the parameters in compartmental models are often unknown, and they can even change over time in the real world, making them difficult to determine. This study proposes an advanced artificial intelligence approach based on physics-informed neural networks (PINNs) to estimate time-varying parameters from given data for the compartmental model. Our proposed PINNs method captures the complex dynamics of COVID-19 by integrating a modified Susceptible-Exposed-Infectious-Recovered-Death (SEIRD) compartmental model with deep neural networks. Specifically, we modelled the system of ODEs as one network and the time-varying parameters as another network to address significant unknown parameters and limited data. Such structure of the PINNs method is in line with the prior epidemiological correlations and comprises the mismatch between available data and network output and the residual of ODEs. The experimental findings on real-world reported data data have demonstrated that our method robustly and accurately learns the dynamics and forecasts future states. Moreover, as more data becomes available, our proposed PINNs method can be successfully extended to other regions and infectious diseases.
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Affiliation(s)
- Xiao Ning
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, 2 Sipailou, Nanjing 210096, China
| | - Jinxing Guan
- Center for Global Health, Departments of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Xi-An Li
- Ceyear Technology Co., Ltd., 98 Xiangjiang Road, Qingdao 266000, China
| | - Yongyue Wei
- Center for Global Health, Departments of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China
- Public Health and Epidemic Preparedness and Response Center, Peking University, Xueyuan Road, Haidian District, Beijing 100191, China
| | - Feng Chen
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, 2 Sipailou, Nanjing 210096, China
- Center for Global Health, Departments of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China
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19
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Fitz-Simon N, Ferguson J, Alvarez-Iglesias A, Sofonea MT, Kamiya T. Understanding the role of mask-wearing during COVID-19 on the island of Ireland. ROYAL SOCIETY OPEN SCIENCE 2023; 10:221540. [PMID: 37476519 PMCID: PMC10354478 DOI: 10.1098/rsos.221540] [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: 11/30/2022] [Accepted: 06/30/2023] [Indexed: 07/22/2023]
Abstract
Non-pharmaceutical interventions have played a key role in managing the COVID-19 pandemic, but it is challenging to estimate their impacts on disease spread and outcomes. On the island of Ireland, population mobility restrictions were imposed during the first wave, but mask-wearing was not mandated until about six months into the pandemic. We use data on mask-wearing, mobility, and season, over the first year of the pandemic to predict independently the weekly infectious contact estimated by an epidemiological model. Using our models, we make counterfactual predictions of infectious contact, and ensuing hospitalizations, under a hypothetical intervention where 90% of the population wore masks from the beginning of community spread until the dates of the mask mandates. Over periods including the first wave of the pandemic, there were 1601 hospitalizations with COVID-19 in Northern Ireland and 1521 in the Republic of Ireland. Under the counterfactual mask-wearing scenario, we estimate 512 (95% CI 400, 730) and 344 (95% CI 266, 526) hospitalizations in the respective jurisdictions during the same periods. This could be partly due to other factors that were also changing over time.
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Affiliation(s)
- Nicola Fitz-Simon
- School of Mathematical and Statistical Sciences, University of Galway, Galway, Republic of Ireland
- HRB Clinical Research Facility, University of Galway, Galway, Republic of Ireland
| | - John Ferguson
- HRB Clinical Research Facility, University of Galway, Galway, Republic of Ireland
| | | | | | - Tsukushi Kamiya
- HRB Clinical Research Facility, University of Galway, Galway, Republic of Ireland
- Center for Interdisciplinary Research in Biology (CIRB), Collège de France, CNRS, INSERM, Université PSL, Paris, France
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20
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Mongin D, Buclin CP, Cullati S, Courvoisier DS. COVID-19 Vaccination Rate under Different Political Incentive: A Counterfactual Trend Approach Using Nationwide Data. Vaccines (Basel) 2023; 11:1149. [PMID: 37514965 PMCID: PMC10385043 DOI: 10.3390/vaccines11071149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/19/2023] [Accepted: 06/21/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Background: France implemented a COVID-19 certificate in July 2021 to incentivize the population to uptake COVID-19 vaccines. However, little is known about the variation in its impact across age groups and its dependence on socio-demographic, economic, logistic, or political factors. (2) Methods: Using France's weekly first dose vaccination rate, a counterfactual trend approach allowed for the estimation of the vaccination rate across age groups at a small geographical level before and after the implementation of the health pass. The effect of the health pass was operationalized as the vaccination rate among those who would not be vaccinated without it. (3) Results: Vaccination before the health pass varied greatly among age groups and was mainly influenced by territory (lower in rural and overseas territories when compared to urban and metropolitan ones), political beliefs, and socio-economic disparities. Vaccine logistics played a minor but significant role, while the impact of COVID-19 did not affect the vaccination rate. The health pass increased the vaccination overall but with varying efficiency across groups. It convinced mainly young people politically close to the governmental vaccination strategy and living in urban metropolitan areas with low socio-economical discrepancies. The selected variables explained most of the variability of the vaccination rate before the health pass; they explained, at most, a third of the variation in the health pass effect on vaccination. (4) Conclusions: From a public health perspective, the French health pass increased the overall vaccination, but failed to promote preventive behaviours in all segments of society, particularly in vulnerable communities.
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Affiliation(s)
- Denis Mongin
- Faculty of Medicine, University of Geneva, CH-1211 Geneva, Switzerland
| | - Clement P Buclin
- Faculty of Medicine, University of Geneva, CH-1211 Geneva, Switzerland
| | - Stephane Cullati
- Division Quality of Care, Geneva University Hospitals, CH-1211 Geneva, Switzerland
- Population Health Laboratory (#PopHealthLab), Faculty of Science and Medicine, University of Fribourg, CH-1700 Fribourg, Switzerland
| | - Delphine S Courvoisier
- Faculty of Medicine, University of Geneva, CH-1211 Geneva, Switzerland
- Division Quality of Care, Geneva University Hospitals, CH-1211 Geneva, Switzerland
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21
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Wang K, Han X, Dong L, Chen XJ, Xiu G, Kwan MP, Liu Y. Quantifying the spatial spillover effects of non-pharmaceutical interventions on pandemic risk. Int J Health Geogr 2023; 22:13. [PMID: 37286988 DOI: 10.1186/s12942-023-00335-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/26/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Non-pharmaceutical interventions (NPIs) implemented in one place can affect neighboring regions by influencing people's behavior. However, existing epidemic models for NPIs evaluation rarely consider such spatial spillover effects, which may lead to a biased assessment of policy effects. METHODS Using the US state-level mobility and policy data from January 6 to August 2, 2020, we develop a quantitative framework that includes both a panel spatial econometric model and an S-SEIR (Spillover-Susceptible-Exposed-Infected-Recovered) model to quantify the spatial spillover effects of NPIs on human mobility and COVID-19 transmission. RESULTS The spatial spillover effects of NPIs explain [Formula: see text] [[Formula: see text] credible interval: 52.8-[Formula: see text]] of national cumulative confirmed cases, suggesting that the presence of the spillover effect significantly enhances the NPI influence. Simulations based on the S-SEIR model further show that increasing interventions in only a few states with larger intrastate human mobility intensity significantly reduce the cases nationwide. These region-based interventions also can carry over to interstate lockdowns. CONCLUSIONS Our study provides a framework for evaluating and comparing the effectiveness of different intervention strategies conditional on NPI spillovers, and calls for collaboration from different regions.
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Affiliation(s)
- Keli Wang
- Institute of Remote Sensing and Geographical Information Systems, School of Earth and Space Sciences, Peking University, Beijing, China
- Beijing Key Lab of Spatial Information Integration & Its Applications, Peking University, Beijing, 100091, China
| | - Xiaoyi Han
- The Wang Yanan Institute for Studies in Economics (WISE), Xiamen University, Xiamen, 361005, China
- School of Economics, Xiamen University, Xiamen, 361005, China
| | - Lei Dong
- Institute of Remote Sensing and Geographical Information Systems, School of Earth and Space Sciences, Peking University, Beijing, China
- Beijing Key Lab of Spatial Information Integration & Its Applications, Peking University, Beijing, 100091, China
| | - Xiao-Jian Chen
- Institute of Remote Sensing and Geographical Information Systems, School of Earth and Space Sciences, Peking University, Beijing, China
- Beijing Key Lab of Spatial Information Integration & Its Applications, Peking University, Beijing, 100091, China
| | - Gezhi Xiu
- Institute of Remote Sensing and Geographical Information Systems, School of Earth and Space Sciences, Peking University, Beijing, China
- Beijing Key Lab of Spatial Information Integration & Its Applications, Peking University, Beijing, 100091, China
| | - Mei-Po Kwan
- Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Hong Kong, China
- Department of Geography and Resource Management, The Chinese University of Hong Kong, Hong Kong, China
| | - Yu Liu
- Institute of Remote Sensing and Geographical Information Systems, School of Earth and Space Sciences, Peking University, Beijing, China.
- Beijing Key Lab of Spatial Information Integration & Its Applications, Peking University, Beijing, 100091, China.
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22
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Jing S, Milne R, Wang H, Xue L. Vaccine hesitancy promotes emergence of new SARS-CoV-2 variants. J Theor Biol 2023; 570:111522. [PMID: 37210068 DOI: 10.1016/j.jtbi.2023.111522] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/30/2023] [Accepted: 05/03/2023] [Indexed: 05/22/2023]
Abstract
The successive emergence of SARS-CoV-2 mutations has led to an unprecedented increase in COVID-19 incidence worldwide. Currently, vaccination is considered to be the best available solution to control the ongoing COVID-19 pandemic. However, public opposition to vaccination persists in many countries, which can lead to increased COVID-19 caseloads and hence greater opportunities for vaccine-evasive mutant strains to arise. To determine the extent that public opinion regarding vaccination can induce or hamper the emergence of new variants, we develop a model that couples a compartmental disease transmission framework featuring two strains of SARS-CoV-2 with game theoretical dynamics on whether or not to vaccinate. We combine semi-stochastic and deterministic simulations to explore the effect of mutation probability, perceived cost of receiving vaccines, and perceived risks of infection on the emergence and spread of mutant SARS-CoV-2 strains. We find that decreasing the perceived costs of being vaccinated and increasing the perceived risks of infection (that is, decreasing vaccine hesitation) will decrease the possibility of vaccine-resistant mutant strains becoming established by about fourfold for intermediate mutation rates. Conversely, we find increasing vaccine hesitation to cause both higher probability of mutant strains emerging and more wild-type cases after the mutant strain has appeared. We also find that once a new variant has emerged, perceived risk of being infected by the original variant plays a much larger role than perceptions of the new variant in determining future outbreak characteristics. Furthermore, we find that rapid vaccination under non-pharmaceutical interventions is a highly effective strategy for preventing new variant emergence, due to interaction effects between non-pharmaceutical interventions and public support for vaccination. Our findings indicate that policies that combine combating vaccine-related misinformation with non-pharmaceutical interventions (such as reducing social contact) will be the most effective for avoiding the establishment of harmful new variants.
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Affiliation(s)
- Shuanglin Jing
- College of Mathematical Sciences, Harbin Engineering University, Harbin, Heilongjiang, 150001, China
| | - Russell Milne
- Department of Mathematical and Statistical Sciences & Interdisciplinary Lab for Mathematical Ecology and Epidemiology, University of Alberta, Edmonton, Alberta T6G 2R3, Canada
| | - Hao Wang
- Department of Mathematical and Statistical Sciences & Interdisciplinary Lab for Mathematical Ecology and Epidemiology, University of Alberta, Edmonton, Alberta T6G 2R3, Canada.
| | - Ling Xue
- College of Mathematical Sciences, Harbin Engineering University, Harbin, Heilongjiang, 150001, China
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23
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Thaivalappil A, Young I, Pearl DL, Zhang R, Papadopoulos A. A Cross-Sectional Study and Observational Assessment of Shoppers' COVID-19 Prevention Behaviors in Southwestern Ontario, Canada. Disaster Med Public Health Prep 2023; 17:e384. [PMID: 37154269 DOI: 10.1017/dmp.2023.48] [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: 05/10/2023]
Abstract
OBJECTIVE The aim of this study was to observe the level of alcohol-based sanitizer, mask use, and physical distancing across indoor community settings in Guelph, ON, Canada, and to identify potential barriers to practicing these behaviors. METHODS Shoppers were observed in June 2022 across 21 establishments. Discrete in-person observations were conducted and electronically recorded using smartphones. Multilevel logistic regression models were fitted to identify possible covariates for the 3 behavioral outcomes. RESULTS Of 946 observed shoppers, 69% shopped alone, 72% had at least 1 hand occupied, 26% touched their face, 29% physically distanced ≥ 2 m, 6% used hand sanitizer, and 29% wore masks. Sanitizer use was more commonly observed among people who wore masks and in establishments with coronavirus disease (COVID-19) signage posted at the entrance. Mask use was more commonly observed during days without precipitation and in establishments with some or all touch-free entrances. Shoppers more commonly physically distanced ≥ 2 m when they were shopping alone. CONCLUSIONS This supports evidence for environmental context influencing COVID-19 preventive behaviors. Intervention efforts aimed at visible signage, tailored messaging, and redesigning spaces to facilitate preventive behaviors may be effective at increasing adherence during outbreaks.
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Affiliation(s)
| | - Ian Young
- School of Occupational and Public Health, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - David L Pearl
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
| | - Ruijia Zhang
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, Ontario, Canada
| | - Andrew Papadopoulos
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
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24
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Xu S, Li J, Wang H, Wang F, Yin Z, Wang Z. Real-world effectiveness and factors associated with effectiveness of inactivated SARS-CoV-2 vaccines: a systematic review and meta-regression analysis. BMC Med 2023; 21:160. [PMID: 37106390 PMCID: PMC10134725 DOI: 10.1186/s12916-023-02861-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 04/04/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND The two inactivated SARS-CoV-2 vaccines, CoronaVac and BBIBP-CorV, have been widely used to control the COVID-19 pandemic. The influence of multiple factors on inactivated vaccine effectiveness (VE) during long-term use and against variants is not well understood. METHODS We selected published or preprinted articles from PubMed, Embase, Scopus, Web of Science, medRxiv, BioRxiv, and the WHO COVID-19 database by 31 August 2022. We included observational studies that assessed the VE of completed primary series or homologous booster against SARS-CoV-2 infection or severe COVID-19. We used DerSimonian and Laird random-effects models to calculate pooled estimates and conducted multiple meta-regression with an information theoretic approach based on Akaike's Information Criterion to select the model and identify the factors associated with VE. RESULTS Fifty-one eligible studies with 151 estimates were included. For prevention of infection, VE associated with study region, variants, and time since vaccination; VE was significantly decreased against Omicron compared to Alpha (P = 0.021), primary series VE was 52.8% (95% CI, 43.3 to 60.7%) against Delta and 16.4% (95% CI, 9.5 to 22.8%) against Omicron, and booster dose VE was 65.2% (95% CI, 48.3 to 76.6%) against Delta and 20.3% (95% CI, 10.5 to 28.0%) against Omicron; primary VE decreased significantly after 180 days (P = 0.022). For the prevention of severe COVID-19, VE associated with vaccine doses, age, study region, variants, study design, and study population type; booster VE increased significantly (P = 0.001) compared to primary; though VE decreased significantly against Gamma (P = 0.034), Delta (P = 0.001), and Omicron (P = 0.001) compared to Alpha, primary and booster VEs were all above 60% against each variant. CONCLUSIONS Inactivated vaccine protection against SARS-CoV-2 infection was moderate, decreased significantly after 6 months following primary vaccination, and was restored by booster vaccination. VE against severe COVID-19 was greatest after boosting and did not decrease over time, sustained for over 6 months after the primary series, and more evidence is needed to assess the duration of booster VE. VE varied by variants, most notably against Omicron. It is necessary to ensure booster vaccination of everyone eligible for SARS-CoV-2 vaccines and continue monitoring virus evolution and VE. TRIAL REGISTRATION PROSPERO, CRD42022353272.
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Affiliation(s)
- Shiyao Xu
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Jincheng Li
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Hongyuan Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Fuzhen Wang
- Chinese Center for Disease Control and Prevention, National Immunization Programme, Beijing, China
| | - Zundong Yin
- Chinese Center for Disease Control and Prevention, National Immunization Programme, Beijing, China.
| | - Zhifeng Wang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China.
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25
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The added effect of non-pharmaceutical interventions and lifestyle behaviors on vaccine effectiveness against severe COVID-19 in Chile: a matched case-double control study. Vaccine 2023; 41:2947-2955. [PMID: 37024408 PMCID: PMC10067460 DOI: 10.1016/j.vaccine.2023.03.060] [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: 01/12/2023] [Revised: 03/27/2023] [Accepted: 03/28/2023] [Indexed: 04/05/2023]
Abstract
Background All World Health Organization approved vaccines have demonstrated relatively high protection against moderate to severe COVID-19. Prospective vaccine effectiveness (VE) designs with first-hand data and population-based controls are nevertheless rare. Neighborhood compared to hospitalized controls, may differ in non-pharmaceutical interventions (NPI) compliance, which may influence VE results in real-world settings. We aimed to determine VE against COVID-19 intensive-care-unit (ICU) admission using hospital and community-matched controls in a prospective design. Methods We conducted a multicenter, observational study of matched cases and controls (1:3) in adults ≧18 from May to July 2021. For each case, a hospital control and two community controls were matched by age, gender, and hospital admission date or neighborhood of residence. Conditional logistic regression models were built, including interaction terms between NPIs, lifestyle behaviors, and vaccination status; the model’s β coefficients represent the added effect these terms had on COVID-19 VE. Results Cases and controls differed in several factors including education level, obesity prevalence, and behaviors such as compliance with routine vaccinations, use of facemasks, and routine handwashing. VE was 98·2% for full primary vaccination and 85·6% for partial vaccination when compared to community controls. VE tended to be higher when compared to community versus hospital controls, but the difference was not significant. A significant added effect to vaccination in reducing COVID-19 ICU admission was regular facemask use and VE was higher among individuals non-compliant with the national vaccine program, nor routine medical controls during the prior year. Conclusion VE against COVID-19 ICU admission in this stringent prospective case-double control study reached 98% two weeks after full primary vaccination, confirming the high effectiveness provided by earlier studies. Face mask use and hand washing were independent protective factors, the former adding additional benefit to VE. VE was significantly higher in subjects with increased risk behaviors.
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26
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Cui Q, Shi Z, Yimamaidi D, Hu B, Zhang Z, Saqib M, Zohaib A, Gulnara B, Yersyn M, Hu Z, Li S. Dynamic variations in COVID-19 with the SARS-CoV-2 Omicron variant in Kazakhstan and Pakistan. Infect Dis Poverty 2023; 12:18. [PMID: 36918974 PMCID: PMC10014408 DOI: 10.1186/s40249-023-01072-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/21/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND The ongoing coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) and the Omicron variant presents a formidable challenge for control and prevention worldwide, especially for low- and middle-income countries (LMICs). Hence, taking Kazakhstan and Pakistan as examples, this study aims to explore COVID-19 transmission with the Omicron variant at different contact, quarantine and test rates. METHODS A disease dynamic model was applied, the population was segmented, and three time stages for Omicron transmission were established: the initial outbreak, a period of stabilization, and a second outbreak. The impact of population contact, quarantine and testing on the disease are analyzed in five scenarios to analysis their impacts on the disease. Four statistical metrics are employed to quantify the model's performance, including the correlation coefficient (CC), normalized absolute error, normalized root mean square error and distance between indices of simulation and observation (DISO). RESULTS Our model has high performance in simulating COVID-19 transmission in Kazakhstan and Pakistan with high CC values greater than 0.9 and DISO values less than 0.5. Compared with the present measures (baseline), decreasing (increasing) the contact rates or increasing (decreasing) the quarantined rates can reduce (increase) the peak values of daily new cases and forward (delay) the peak value times (decreasing 842 and forward 2 days for Kazakhstan). The impact of the test rates on the disease are weak. When the start time of stage II is 6 days, the daily new cases are more than 8 and 5 times the rate for Kazakhstan and Pakistan, respectively (29,573 vs. 3259; 7398 vs. 1108). The impact of the start times of stage III on the disease are contradictory to those of stage II. CONCLUSIONS For the two LMICs, Kazakhstan and Pakistan, stronger control and prevention measures can be more effective in combating COVID-19. Therefore, to reduce Omicron transmission, strict management of population movement should be employed. Moreover, the timely application of these strategies also plays a key role in disease control.
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Affiliation(s)
- Qianqian Cui
- School of Mathematics and Statistics, Ningxia University, Yinchuan, 750021, Ningxia, China
| | - Zhengli Shi
- Chinese Academy of Sciences Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
| | - Duman Yimamaidi
- State Key Laboratory of Desert and Oasis Ecology, Xinjiang Institute of Ecology and Geography, Chinese Academy of Sciences, Ürümqi, 830011, Xinjiang, China.,Research Center for Ecology and Environment of Central Asia, Chinese Academy of Sciences, Ürümqi, 830011, Xinjiang, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Ben Hu
- Chinese Academy of Sciences Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
| | - Zhuo Zhang
- College of Geography and Remote Sensing Sciences, Xinjiang University, Ürümqi, 830017, China
| | - Muhammad Saqib
- Department of Clinical Medicine and Surgery, Faculty of Veterinary Science, University of Agriculture Faisalabad, Faisalabad, Pakistan
| | - Ali Zohaib
- Department of Microbiology, Faculty of Veterinary and Animal Sciences, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Baikadamova Gulnara
- Veterinary Medicine Department, Kazakh Agrotechnical University, Astana, Kazakhstan
| | | | - Zengyun Hu
- State Key Laboratory of Desert and Oasis Ecology, Xinjiang Institute of Ecology and Geography, Chinese Academy of Sciences, Ürümqi, 830011, Xinjiang, China. .,Research Center for Ecology and Environment of Central Asia, Chinese Academy of Sciences, Ürümqi, 830011, Xinjiang, China. .,University of Chinese Academy of Sciences, Beijing, China.
| | - Shizhu Li
- National Institute of Parasitic Diseases, Chinese Centre for Disease Control and Prevention (Chinese Centre for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Centre for International Research On Tropical Diseases, Shanghai, 200025, China.
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27
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Stein C, Nassereldine H, Sorensen RJD, Amlag JO, Bisignano C, Byrne S, Castro E, Coberly K, Collins JK, Dalos J, Daoud F, Deen A, Gakidou E, Giles JR, Hulland EN, Huntley BM, Kinzel KE, Lozano R, Mokdad AH, Pham T, Pigott DM, Reiner Jr. RC, Vos T, Hay SI, Murray CJL, Lim SS. Past SARS-CoV-2 infection protection against re-infection: a systematic review and meta-analysis. Lancet 2023; 401:833-842. [PMID: 36930674 PMCID: PMC9998097 DOI: 10.1016/s0140-6736(22)02465-5] [Citation(s) in RCA: 113] [Impact Index Per Article: 113.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 02/18/2023]
Abstract
BACKGROUND Understanding the level and characteristics of protection from past SARS-CoV-2 infection against subsequent re-infection, symptomatic COVID-19 disease, and severe disease is essential for predicting future potential disease burden, for designing policies that restrict travel or access to venues where there is a high risk of transmission, and for informing choices about when to receive vaccine doses. We aimed to systematically synthesise studies to estimate protection from past infection by variant, and where data allow, by time since infection. METHODS In this systematic review and meta-analysis, we identified, reviewed, and extracted from the scientific literature retrospective and prospective cohort studies and test-negative case-control studies published from inception up to Sept 31, 2022, that estimated the reduction in risk of COVID-19 among individuals with a past SARS-CoV-2 infection in comparison to those without a previous infection. We meta-analysed the effectiveness of past infection by outcome (infection, symptomatic disease, and severe disease), variant, and time since infection. We ran a Bayesian meta-regression to estimate the pooled estimates of protection. Risk-of-bias assessment was evaluated using the National Institutes of Health quality-assessment tools. The systematic review was PRISMA compliant and was registered with PROSPERO (number CRD42022303850). FINDINGS We identified a total of 65 studies from 19 different countries. Our meta-analyses showed that protection from past infection and any symptomatic disease was high for ancestral, alpha, beta, and delta variants, but was substantially lower for the omicron BA.1 variant. Pooled effectiveness against re-infection by the omicron BA.1 variant was 45·3% (95% uncertainty interval [UI] 17·3-76·1) and 44·0% (26·5-65·0) against omicron BA.1 symptomatic disease. Mean pooled effectiveness was greater than 78% against severe disease (hospitalisation and death) for all variants, including omicron BA.1. Protection from re-infection from ancestral, alpha, and delta variants declined over time but remained at 78·6% (49·8-93·6) at 40 weeks. Protection against re-infection by the omicron BA.1 variant declined more rapidly and was estimated at 36·1% (24·4-51·3) at 40 weeks. On the other hand, protection against severe disease remained high for all variants, with 90·2% (69·7-97·5) for ancestral, alpha, and delta variants, and 88·9% (84·7-90·9) for omicron BA.1 at 40 weeks. INTERPRETATION Protection from past infection against re-infection from pre-omicron variants was very high and remained high even after 40 weeks. Protection was substantially lower for the omicron BA.1 variant and declined more rapidly over time than protection against previous variants. Protection from severe disease was high for all variants. The immunity conferred by past infection should be weighed alongside protection from vaccination when assessing future disease burden from COVID-19, providing guidance on when individuals should be vaccinated, and designing policies that mandate vaccination for workers or restrict access, on the basis of immune status, to settings where the risk of transmission is high, such as travel and high-occupancy indoor settings. FUNDING Bill & Melinda Gates Foundation, J Stanton, T Gillespie, and J and E Nordstrom.
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28
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Wang C, Shen L, Weng W. Modelling physical contacts to evaluate the individual risk in a dense crowd. Sci Rep 2023; 13:3929. [PMID: 36894613 PMCID: PMC9995744 DOI: 10.1038/s41598-023-31148-z] [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: 08/20/2022] [Accepted: 03/07/2023] [Indexed: 03/11/2023] Open
Abstract
Tumble and stampede in a dense crowd may be caused by irrational behaviours of individuals and always troubles the safety management of crowd activities. Risk evaluation based on pedestrian dynamical models can be regarded as an effective method of preventing crowd disasters. Here, a method depending on a combination of collision impulses and pushing forces was used to model the physical contacts between individuals in a dense crowd, by which the acceleration error during physical contacts caused by a traditional dynamical equation can be avoided. The human domino effect in a dense crowd could be successfully reproduced, and the crushing and trampling risk of a microscopic individual in a crowd could be quantitatively evaluated separately. This method provides a more reliable and integral data foundation for evaluating individual risk that shows better portability and repeatability than macroscopic crowd risk evaluation methods and will also be conducive to preventing crowd disasters.
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Affiliation(s)
- Chongyang Wang
- Department of Engineering Physics, Institute of Public Safety Research, Tsinghua University, Beijing, China.,Beijing Key Laboratory of City Integrated Emergency Response Science, Tsinghua University, Beijing, China.,China Petrochemical Corporation, Beijing, China
| | - Liangchang Shen
- Department of Engineering Physics, Institute of Public Safety Research, Tsinghua University, Beijing, China.,Beijing Key Laboratory of City Integrated Emergency Response Science, Tsinghua University, Beijing, China
| | - Wenguo Weng
- Department of Engineering Physics, Institute of Public Safety Research, Tsinghua University, Beijing, China. .,Beijing Key Laboratory of City Integrated Emergency Response Science, Tsinghua University, Beijing, China.
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29
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Sornette D, Wu K. Coupled System Approach to Healthy Earth Environments and Individual Human Resilience. SUSTAINABLE HORIZONS 2023:100050. [PMCID: PMC9981524 DOI: 10.1016/j.horiz.2023.100050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
The SARS-CoV-2 pandemic has stressed our social organizations, health care systems and economies at a level not experienced since WWII or the last “Spanish flu” pandemic of 1918. This shock provides a real-life test of the resilience of human societies and of individuals, challenging our understanding and level of preparation. While hurried coercive non-pharmaceutical measures and vaccinations were the main responses, for the future, we propose a coupled double-system approach linking efforts to improve both human well-being and Earth environmental health. Concretely, this means linking (i) the build-up of individual health resilience using holistic medical system perspectives applied to each person with (ii) efforts to depollute and achieve more healthy Earth environments that are intrinsic pillars of humans’ health and wealth. The push to fight Earth ecological damages towards environmental sustainability should be rethought as being motivated by recovering an ecosystem in which each own personal biological ecosystem (i.e., each person's homeostatic balance) can strive again. We propose to prioritize Human-Environment-Health initiatives for depolluting the environment and of our immune systems, as well as improving individual responsibility and resilience.
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Affiliation(s)
| | - Ke Wu
- Corresponding: Institute of Risk Analysis, Prediction and Management (Risks-X), Academy for Advanced Interdisciplinary Studies, Southern University of Science and Technology (SUSTech), Shenzhen, China, 518055. +86 15201128638
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30
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Ning X, Jia L, Wei Y, Li XA, Chen F. Epi-DNNs: Epidemiological priors informed deep neural networks for modeling COVID-19 dynamics. Comput Biol Med 2023; 158:106693. [PMID: 36996662 PMCID: PMC9970927 DOI: 10.1016/j.compbiomed.2023.106693] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/05/2023] [Accepted: 02/14/2023] [Indexed: 03/04/2023]
Abstract
Differential equations-based epidemic compartmental models and deep neural networks-based artificial intelligence (AI) models are powerful tools for analyzing and fighting the transmission of COVID-19. However, the capability of compartmental models is limited by the challenges of parameter estimation, while AI models fail to discover the evolutionary pattern of COVID-19 and lack explainability. This paper aims to provide a novel method (called Epi-DNNs) by integrating compartmental models and deep neural networks (DNNs) to model the complex dynamics of COVID-19. In the proposed Epi-DNNs method, the neural network is designed to express the unknown parameters in the compartmental model and the Runge–Kutta method is implemented to solve the ordinary differential equations (ODEs) so as to give the values of the ODEs at a given time. Specifically, the discrepancy between predictions and observations is incorporated into the loss function, then the defined loss is minimized and applied to identify the best-fitted parameters governing the compartmental model. Furthermore, we verify the performance of Epi-DNNs on the real-world reported COVID-19 data on the Omicron epidemic in Shanghai covering February 25 to May 27, 2022. The experimental findings on the synthesized data have revealed its effectiveness in COVID-19 transmission modeling. Moreover, the inferred parameters from the proposed Epi-DNNs method yield a predictive compartmental model, which can serve to forecast future dynamics.
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Affiliation(s)
- Xiao Ning
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, 2 Sipailou, Nanjing, 210096, PR China
| | - Linlin Jia
- The COBRA Lab, INSA Rouen Normandie, 1 Rue Tesniere, Mont-Saint-Aignan, 76821, France
| | - Yongyue Wei
- Center for Global Health, Departments of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Address Two, Nanjing, 21166, PR China,Public Health and Epidemic Preparedness and Response Center, Peking University, Xueyuan Road, Haidian District, Beijing, 100191, PR China
| | - Xi-An Li
- Ceyear Technologies Co., Ltd, 98 Xiangjiang Road, Qingdao, 266000, PR China,Corresponding author
| | - Feng Chen
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, 2 Sipailou, Nanjing, 210096, PR China,Center for Global Health, Departments of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Address Two, Nanjing, 21166, PR China,Corresponding author at: State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, 2 Sipailou, Nanjing, 210096, PR China
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Hirotsu Y, Kakizaki Y, Saito A, Tsutsui T, Hanawa S, Yamaki H, Ide S, Kawaguchi M, Kobayashi H, Miyashita Y, Omata M. Lung tropism in hospitalized patients following infection with SARS-CoV-2 variants from D614G to Omicron BA.2. COMMUNICATIONS MEDICINE 2023; 3:32. [PMID: 36841870 PMCID: PMC9959956 DOI: 10.1038/s43856-023-00261-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 02/10/2023] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND The genetic and pathogenic characteristics of SARS-CoV-2 have evolved from the original isolated strains; however, the changes in viral virulence have not been fully defined. In this study, we analyzed the association between the severity of the pathogenesis of pneumonia in humans and SARS-CoV-2 variants that have been prevalent to date. METHODS We examined changes in the variants and tropism of SARS-CoV-2. A total of 514 patients admitted between February 2020 and August 2022 were included and evaluated for pneumonia by computed tomography (CT) as a surrogate of viral tropism. RESULTS The prevalence of pneumonia for each variant was as follows: D614G (57%, 65/114), Alpha (67%, 41/61), Delta (49%, 41/84), Omicron BA.1.1 (26%, 43/163), and Omicron BA.2 (11%, 10/92). The pneumonia prevalence in unvaccinated patients progressively declined from 70% to 11% as the variants changed: D614G (56%, 61/108), Alpha (70%, 26/37), Delta (60%, 38/63), BA.1.1 (52%, 15/29), and BA.2 (11%, 2/19). The presence of pneumonia in vaccinated patients was as follows: Delta (16%, 3/19), BA.1.1 (21%, 27/129), and BA.2 (11%, 8/73). Compared with D614G, the areas of lung involvement were also significantly reduced in BA.1.1 and BA.2 variants. CONCLUSIONS Compared with previous variants, there was a marked decrease in pneumonia prevalence and lung involvement in patients infected with Omicron owing to decreased tropism in the lungs that hindered viral proliferation in the alveolar epithelial tissue. Nevertheless, older, high-risk patients with comorbidities who are infected with an Omicron variant can still develop pneumonia and require early treatment.
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Affiliation(s)
- Yosuke Hirotsu
- Genome Analysis Center, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, Japan.
| | - Yumiko Kakizaki
- grid.417333.10000 0004 0377 4044Lung Cancer and Respiratory Disease Center, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, Japan
| | - Akitoshi Saito
- Department of Radiology, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, Japan
| | - Toshiharu Tsutsui
- grid.417333.10000 0004 0377 4044Lung Cancer and Respiratory Disease Center, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, Japan
| | - Syunya Hanawa
- grid.417333.10000 0004 0377 4044Lung Cancer and Respiratory Disease Center, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, Japan
| | - Haruna Yamaki
- grid.417333.10000 0004 0377 4044Lung Cancer and Respiratory Disease Center, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, Japan
| | - Syuichiro Ide
- grid.417333.10000 0004 0377 4044Lung Cancer and Respiratory Disease Center, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, Japan
| | - Makoto Kawaguchi
- grid.417333.10000 0004 0377 4044Lung Cancer and Respiratory Disease Center, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, Japan
| | - Hiroaki Kobayashi
- grid.417333.10000 0004 0377 4044Lung Cancer and Respiratory Disease Center, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, Japan
| | - Yoshihiro Miyashita
- grid.417333.10000 0004 0377 4044Lung Cancer and Respiratory Disease Center, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, Japan
| | - Masao Omata
- grid.417333.10000 0004 0377 4044Department of Gastroenterology, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, Japan ,grid.26999.3d0000 0001 2151 536XThe University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
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Kister P, Tonetto L. On the importance of structural equivalence in temporal networks for epidemic forecasting. Sci Rep 2023; 13:866. [PMID: 36650269 PMCID: PMC9843108 DOI: 10.1038/s41598-023-28126-w] [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: 08/08/2022] [Accepted: 01/13/2023] [Indexed: 01/19/2023] Open
Abstract
Understanding how a disease spreads in a population is a first step to preparing for future epidemics, and machine learning models are a useful tool to analyze the spreading process of infectious diseases. For effective predictions of these spreading processes, node embeddings are used to encode networks based on the similarity between nodes into feature vectors, i.e., higher dimensional representations of human contacts. In this work, we evaluated the impact of homophily and structural equivalence on node2vec embedding for disease spread prediction by testing them on real world temporal human contact networks. Our results show that structural equivalence is a useful indicator for the infection status of a person. Embeddings that are balanced towards the preservation of structural equivalence performed better than those that focus on the preservation of homophily, with an average improvement of 0.1042 in the f1-score (95% CI 0.051 to 0.157). This indicates that structurally equivalent nodes behave similarly during an epidemic (e.g., expected time of a disease onset). This observation could greatly improve predictions of future epidemics where only partial information about contacts is known, thereby helping determine the risk of infection for different groups in the population.
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Kohls E, Guenthner L, Baldofski S, Brock T, Schuhr J, Rummel-Kluge C. Two years COVID-19 pandemic: Development of university students' mental health 2020-2022. Front Psychiatry 2023; 14:1122256. [PMID: 37091715 PMCID: PMC10117945 DOI: 10.3389/fpsyt.2023.1122256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/21/2023] [Indexed: 04/25/2023] Open
Abstract
Background The literature indicates a negative impact on the mental health of university students during the COVID-19 pandemic. It remains unclear if this negative impact persists even after lockdown measures are lifted. The current study therefore investigates the mental health status of students by drawing on two previous studies the present study seeks to investigate differences in the mental health status across three time points. Methods A cross-sectional, anonymous online survey among students of six universities was conducted between April and May 2022 (N = 5,510). Symptoms of depression, anxiety, hazardous alcohol use and eating disorders as well as social and emotional variables were assessed utilizing standardized instruments. Risk- and protective factors for severity of depressive and anxiety symptoms were investigated using multiple regression models. Differences in e.g., symptoms of depression across three time points were assessed with one-way analysis of variance. Results More than one third of students exhibited clinically relevant symptoms of depression (35.5%), hazardous alcohol use (33.0-35.5% depending on gender) or anxiety disorder (31.1%). Taken together, almost two out of three (61.4%) students reported clinically relevant symptoms in at least one of the aforementioned symptom patterns, while almost one fifth of students reported suicidal ideation or thoughts of self-harm (19.6%). Higher perceived stress and loneliness significantly predicted higher levels of depressive symptoms, while resilience and social support were identified as protective factors. Compared to 2020 and 2021, levels of depressive symptoms were significantly reduced in 2022, levels of hazardous alcohol consumption showed a small but significant increase from 2021 to 2022. Worryingly, prevalence of suicidal ideation was the highest yet, being significantly higher than in 2020 (14.5%) and 2021 (16.5%). Conclusion These results confirm previous results that the pandemic had and still has a negative impact on the mental health of university students. The present study broadens this view by the fact that some areas seem to recover quicker, while others seem to increase worryingly. Especially the persistent rise in suicidal ideation from 2020 to 2021 and to 2022, a constant reduction in reported social support and associated perceived loneliness is concerning. The claim for low-threshold and accessible mental health support for university students remains the same as in the beginning of the pandemic.
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Affiliation(s)
- Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University Leipzig Medical Center, Leipzig University, Leipzig, Germany
| | - Lukas Guenthner
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Sabrina Baldofski
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Tanja Brock
- Centre for Research, Further Education and Consulting, University of Applied Sciences for Social Work, Education and Nursing Dresden, Dresden, Germany
| | - Jan Schuhr
- Centre for Research, Further Education and Consulting, University of Applied Sciences for Social Work, Education and Nursing Dresden, Dresden, Germany
| | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University Leipzig Medical Center, Leipzig University, Leipzig, Germany
- *Correspondence: Christine Rummel-Kluge
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Montcho Y, Klingler P, Lokonon BE, Tovissodé CF, Glèlè Kakaï R, Wolkewitz M. Intensity and lag-time of non-pharmaceutical interventions on COVID-19 dynamics in German hospitals. Front Public Health 2023; 11:1087580. [PMID: 36950092 PMCID: PMC10025539 DOI: 10.3389/fpubh.2023.1087580] [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: 11/02/2022] [Accepted: 02/14/2023] [Indexed: 03/08/2023] Open
Abstract
Introduction Evaluating the potential effects of non-pharmaceutical interventions on COVID-19 dynamics is challenging and controversially discussed in the literature. The reasons are manifold, and some of them are as follows. First, interventions are strongly correlated, making a specific contribution difficult to disentangle; second, time trends (including SARS-CoV-2 variants, vaccination coverage and seasonality) influence the potential effects; third, interventions influence the different populations and dynamics with a time delay. Methods In this article, we apply a distributed lag linear model on COVID-19 data from Germany from January 2020 to June 2022 to study intensity and lag time effects on the number of hospital patients and the number of prevalent intensive care patients diagnosed with polymerase chain reaction tests. We further discuss how the findings depend on the complexity of accounting for the seasonal trends. Results and discussion Our findings show that the first reducing effect of non-pharmaceutical interventions on the number of prevalent intensive care patients before vaccination can be expected not before a time lag of 5 days; the main effect is after a time lag of 10-15 days. In general, we denote that the number of hospital and prevalent intensive care patients decrease with an increase in the overall non-pharmaceutical interventions intensity with a time lag of 9 and 10 days. Finally, we emphasize a clear interpretation of the findings noting that a causal conclusion is challenging due to the lack of a suitable experimental study design.
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Affiliation(s)
- Yvette Montcho
- Laboratoire de Biomathématiques et d'Estimations Forestières, Université d'Abomey-Calavi, Cotonou, Benin
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
- *Correspondence: Yvette Montcho
| | - Paul Klingler
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Bruno Enagnon Lokonon
- Laboratoire de Biomathématiques et d'Estimations Forestières, Université d'Abomey-Calavi, Cotonou, Benin
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | | | - Romain Glèlè Kakaï
- Laboratoire de Biomathématiques et d'Estimations Forestières, Université d'Abomey-Calavi, Cotonou, Benin
| | - Martin Wolkewitz
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
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Considerations in Understanding Vaccine Effectiveness. Vaccines (Basel) 2022; 11:vaccines11010020. [PMID: 36679865 PMCID: PMC9864852 DOI: 10.3390/vaccines11010020] [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: 12/07/2022] [Revised: 12/20/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022] Open
Abstract
Although vaccine effectiveness reports are essential to assessing policies on SARS-CoV-2 vaccination, several factors can affect our interpretation of the results. These include the waning of antibodies, the prevailing viral variants at the time of the study, and COVID-19 disease prevalence in the population. Disease prevalence significantly impacts absolute risk reduction and could skew expected efficacy when increased disease prevalence inflates the absolute risk reduction in the face of a constant relative risk reduction. These factors must be considered in the interpretation of vaccine effectiveness to better understand how vaccines can improve disease prevention among the population. We highlight the impact of various factors on vaccine effectiveness.
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Abbas W, M. A. M, Park A, Parveen S, Kim S. Evolution and consequences of individual responses during the COVID-19 outbreak. PLoS One 2022; 17:e0273964. [PMID: 36048847 PMCID: PMC9436131 DOI: 10.1371/journal.pone.0273964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 08/18/2022] [Indexed: 12/01/2022] Open
Abstract
In a long-lasting major disease outbreak such as that of COVID-19, the challenge for public health authorities is to keep people motivated and keen on following safety guidelines. In this study, a compartmental model with a heterogeneous transmission rate (based on awareness) is utilized to hypothesize about the public adoption of preventive guidelines. Three subsequent outbreaks in South Korea, Pakistan, and Japan were analyzed as case studies. The transmission, behavior change, and behavioral change ease rates of the disease were measured in these countries. The parameters were estimated using the maximum likelihood method with an additional identifiability analysis performed to determine the uniqueness of the estimated parameters for quantitatively comparing them during the first three waves of COVID-19. The mathematical analysis and simulation results show that individual responses had a significant effect on the outbreak. Individuals declining to follow the public health guidelines in Korea and Japan between the second and third waves contributed to making the third peak the highest of the three peaks. In Pakistan, however, individual responses to following public health guidelines were maintained between the second and third waves, resulting in the third peak being lower than the first, rather than being associated with the highest transmission rate. Thus, maintaining a high level of awareness is critical for containing the spread. Improvised public health campaigns are recommended to sustain individual attention and maintain a high level of awareness.
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Affiliation(s)
- Wasim Abbas
- Department of Mathematics, Pusan National University, Busan, Korea
| | - Masud M. A.
- Natural Product Informatics Research Center, Korea Institute of Science and Technology, Seoul, Gangneung, South Korea
| | - Anna Park
- Institute of Mathematical Sciences, Pusan National University, Busan, Korea
| | - Sajida Parveen
- Department of Mathematics, Pusan National University, Busan, Korea
| | - Sangil Kim
- Department of Mathematics, Pusan National University, Busan, Korea
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