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Pagen DM, Hanssen DA, van Loo IH, Brinkhues S, den Heijer CD, Dukers-Muijrers NH, Hoebe CJ. The association between SARS-CoV-2 seroprevalence and cross-border mobility for visiting family or friends among Dutch residents of a Euregional province. Health Policy 2024; 143:105056. [PMID: 38537398 DOI: 10.1016/j.healthpol.2024.105056] [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: 06/15/2023] [Revised: 12/11/2023] [Accepted: 03/20/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Border measures were implemented in many countries as infection prevention measures to interrupt between-country COVID-19 transmission. Border closings impact border region residents, as their professional and social lives are often intertwined across national borders. We studied whether crossing borders to visit family/friends in neighbouring countries (cross-border mobility) was associated with SARS-CoV-2 seroprevalence in Dutch Euregional residents. METHODS SARS-CoV-2 serostatus (negative/positive) was assessed (pre-vaccination) using laboratory testing to determine previous infection. Visiting Belgian or German family/friends in February-March 2020 was questioned. The association between cross-border mobility and seroprevalence was tested using logistic regression analysis, adjusted for previously identified exposure factors. RESULTS In 9,996 participants, 36.8 % (n = 3,677) reported cross-border family/friends. Of these, one-third (n = 1,306) visited their cross-border family/friends in February-March 2020. Multivariable analyses revealed no positive association between cross-border mobility and seropositivity, for both participants living in a border municipality (ORfamily/friends not visited=0.90 [95 % CI:0.78-1.04], ORfamily/friends visited=0.88 [95 % CI:0.73-1.05]), and for participants not living in a border municipality (ORfamily/friends not visited=0.91 [95 % CI:0.72-1.16], ORfamily/friends visited=0.62 [95 % CI:0.41-0.94]). CONCLUSIONS This study provided no evidence of cross-border mobility as an important exposure factor for SARS-CoV-2. The results of our unique real-world study suggest that cross-border mobility did not substantially contribute to cross-border SARS-CoV-2 transmission in the Netherlands.
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Affiliation(s)
- Demi Me Pagen
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, the Netherlands; Department of Social Medicine, Maastricht University, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.
| | - Daniëlle At Hanssen
- Department of Medical Microbiology, Infectious Diseases and Prevention, Maastricht University Medical Center (MUMC+), Care and Public Health Research Institute (CAPHRI), Maastricht, the Netherlands
| | - Inge Hm van Loo
- Department of Medical Microbiology, Infectious Diseases and Prevention, Maastricht University Medical Center (MUMC+), Care and Public Health Research Institute (CAPHRI), Maastricht, the Netherlands
| | - Stephanie Brinkhues
- Department of Knowledge and Innovation, South Limburg Public Health Service, Heerlen, the Netherlands
| | - Casper Dj den Heijer
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, the Netherlands; Department of Social Medicine, Maastricht University, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Nicole Htm Dukers-Muijrers
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, the Netherlands; Department of Health Promotion, Maastricht University, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Christian Jpa Hoebe
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, the Netherlands; Department of Social Medicine, Maastricht University, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; Department of Medical Microbiology, Infectious Diseases and Prevention, Maastricht University Medical Center (MUMC+), Care and Public Health Research Institute (CAPHRI), Maastricht, the Netherlands
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van Bilsen CJA, Brinkhues S, Hoebe CJPA, Stabourlos C, Moonen CPB, Demarest S, Hanssen DAT, van Loo IHM, Savelkoul PHM, Philippsen D, van der Zanden BAM, Dukers-Muijrers NHTM. Cross-border mobility in the Meuse-Rhine Euroregion: impact of COVID-19 border restrictions on everyday activities and visiting social network members. Front Public Health 2024; 12:1281072. [PMID: 38726234 PMCID: PMC11079879 DOI: 10.3389/fpubh.2024.1281072] [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: 08/22/2023] [Accepted: 03/27/2024] [Indexed: 05/12/2024] Open
Abstract
Introduction Cross-border mobility (CBM) to visit social network members or for everyday activities is an important part of daily life for citizens in border regions, including the Meuse-Rhine Euroregion (EMR: neighboring regions from the Netherlands, Belgium, and Germany). We assessed changes in CBM during the COVID-19 pandemic and how participants experienced border restrictions. Methods Impact of COVID-19 on the EMR' is a longitudinal study using comparative cross-border data collection. In 2021, a random sample of the EMR-population was invited for participation in online surveys to assess current and pre-pandemic CBM. Changes in CBM, experience of border restrictions, and associated factors were analyzed using multinomial and multivariable logistic regression analysis. Results Pre-pandemic, 82% of all 3,543 participants reported any CBM: 31% for social contacts and 79% for everyday activities. Among these, 26% decreased social CBM and 35% decreased CBM for everyday activities by autumn 2021. Negative experience of border restrictions was reported by 45% of participants with pre-pandemic CBM, and was higher (p < 0.05) in Dutch participants (compared to Belgian; aOR= 1.4), cross-border [work] commuters (aOR= 2.2), participants with cross-border social networks of friends, family or acquaintances (aOR= 1.3), and those finding the measures 'limit group size' (aOR= 1.5) and 'minimalize travel' (aOR= 2.0) difficult to adhere to and finding 'minimalize travel' (aOR= 1.6) useless. Discussion CBM for social contacts and everyday activities was substantial in EMR-citizens, but decreased during the pandemic. Border restrictions were valued as negative by a considerable portion of EMR-citizens, especially when having family or friends across the border. When designing future pandemic control strategies, policy makers should account for the negative impact of CBM restrictions on their citizens.
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Affiliation(s)
- Céline J. A. van Bilsen
- Department of Social Medicine, Maastricht University, Care and Public Health Research Institute (CAPHRI), Maastricht, Netherlands
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, Public Health Service South Limburg, Heerlen, Netherlands
| | - Stephanie Brinkhues
- Department of Knowledge & Innovation, Public Health Service South Limburg, Heerlen, Netherlands
| | - Christian J. P. A. Hoebe
- Department of Social Medicine, Maastricht University, Care and Public Health Research Institute (CAPHRI), Maastricht, Netherlands
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, Public Health Service South Limburg, Heerlen, Netherlands
- Department of Medical Microbiology, Infectious Diseases & Infection Prevention, Maastricht University Medical Center (MUMC+), Maastricht, Netherlands
| | | | - Chrissy P. B. Moonen
- Department of Social Medicine, Maastricht University, Care and Public Health Research Institute (CAPHRI), Maastricht, Netherlands
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, Public Health Service South Limburg, Heerlen, Netherlands
| | - Stefaan Demarest
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Daniëlle A. T. Hanssen
- Department of Medical Microbiology, Infectious Diseases & Infection Prevention, Maastricht University Medical Center (MUMC+), Maastricht, Netherlands
- Care and Primary Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Inge H. M. van Loo
- Department of Medical Microbiology, Infectious Diseases & Infection Prevention, Maastricht University Medical Center (MUMC+), Maastricht, Netherlands
- Care and Primary Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Paul H. M. Savelkoul
- Department of Medical Microbiology, Infectious Diseases & Infection Prevention, Maastricht University Medical Center (MUMC+), Maastricht, Netherlands
- Care and Primary Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Dirk Philippsen
- Gesundheitsberichterstattung, Gesundheitsamt Düren, Düren, Germany
| | | | - Nicole H. T. M. Dukers-Muijrers
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, Public Health Service South Limburg, Heerlen, Netherlands
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
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Bazak YL, Sander B, Werker E, Zhumatova S, Worsnop CZ, Lee K. The economic impact of international travel measures used during the COVID-19 pandemic: a scoping review. BMJ Glob Health 2024; 9:e013900. [PMID: 38413100 PMCID: PMC10900439 DOI: 10.1136/bmjgh-2023-013900] [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: 09/07/2023] [Accepted: 02/11/2024] [Indexed: 02/29/2024] Open
Abstract
INTRODUCTION Assessment of the use of travel measures during COVID-19 has focused on their effectiveness in achieving public health objectives. However, the prolonged use of highly varied and frequently changing measures by governments, and their unintended consequences caused, has been controversial. This has led to a call for coordinated decision-making focused on risk-based approaches, which requires better understanding of the broader impacts of international travel measures (ITMs) on individuals and societies. METHODS Our scoping review investigates the literature on the economic impact of COVID-19 ITMs. We searched health, social science and COVID-19-specific databases for empirical studies preprinted or published between 1 January 2020 and 31 October 2023. Evidence was charted using a narrative approach and included jurisdiction of study, ITMs studied, study design, outcome categories, and main findings. RESULTS Twenty-six studies met the inclusion criteria and were included for data extraction. Twelve of them focused on the international travel restrictions implemented in early 2020. Limited attention was given to measures such as entry/exit screening and vaccination requirements. Eight studies focused on high-income countries, 6 on low-income and middle-income countries and 10 studies were comparative although did not select countries by income. Economic outcomes assessed included financial markets (n=13), economic growth (n=4), economic activities (n=1), performance of industries central to international travel (n=9), household-level economic status (n=3) and consumer behaviour (n=1). Empirical methods employed included linear regression (n=17), mathematical modelling (n=3) and mixed strategies (n=6). CONCLUSION Existing studies have begun to provide evidence of the wide-ranging economic impacts resulting from ITMs. However, the small body of research combined with difficulties in isolating the effects of such measures and limitations in available data mean that it is challenging to draw general and robust conclusions. Future research using rigorous empirical methods and high-quality data is needed on this topic.
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Affiliation(s)
- Ying Liu Bazak
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Beate Sander
- University Health Network, Toronto, Ontario, Canada
- University of Toronto Institute of Health Policy Management and Evaluation, Toronto, Ontario, Canada
| | - Eric Werker
- Simon Fraser University Beedie School of Business, Burnaby, British Columbia, Canada
| | - Salta Zhumatova
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | | | - Kelley Lee
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
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Anzai A, Yamasaki S, Bleichrodt A, Chowell G, Nishida A, Nishiura H. Epidemiological impact of travel enhancement on the inter-prefectural importation dynamics of COVID-19 in Japan, 2020. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2023; 20:21499-21513. [PMID: 38124607 DOI: 10.3934/mbe.2023951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Mobility restrictions were widely practiced to reduce contact with others and prevent the spatial spread of COVID-19 infection. Using inter-prefectural mobility and epidemiological data, a statistical model was devised to predict the number of imported cases in each Japanese prefecture. The number of imported cases crossing prefectural borders in 2020 was predicted using inter-prefectural mobility rates based on mobile phone data and prevalence estimates in the origin prefectures. The simplistic model was quantified using surveillance data of cases with an inter-prefectural travel history. Subsequently, simulations were carried out to understand how imported cases vary with the mobility rate and prevalence at the origin. Overall, the predicted number of imported cases qualitatively captured the observed number of imported cases over time. Although Hokkaido and Okinawa are the northernmost and the southernmost prefectures, respectively, they were sensitive to differing prevalence rate in Tokyo and Osaka and the mobility rate. Additionally, other prefectures were sensitive to mobility change, assuming that an increment in the mobility rate was seen in all prefectures. Our findings indicate the need to account for the weight of an inter-prefectural mobility network when implementing countermeasures to restrict human movement. If the mobility rates were maintained lower than the observed rates, then the number of imported cases could have been maintained at substantially lower levels than the observed, thus potentially preventing the unnecessary spatial spread of COVID-19 in late 2020.
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Affiliation(s)
- Asami Anzai
- Graduate School of Medicine, Kyoto University, Yoshidakonoecho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Syudo Yamasaki
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo, Japan
| | - Amanda Bleichrodt
- School of Public Health, Georgia State University, 140 Decatur St., Atlanta, GA 30303, USA
| | - Gerardo Chowell
- School of Public Health, Georgia State University, 140 Decatur St., Atlanta, GA 30303, USA
| | - Atsushi Nishida
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo, Japan
- Tokyo Center for Infectious Disease Control and Prevention, Shinjuku-ku, Tokyo, Japan
| | - Hiroshi Nishiura
- Graduate School of Medicine, Kyoto University, Yoshidakonoecho, Sakyo-ku, Kyoto 606-8501, Japan
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Ludolph R, Takahashi R, Shroff ZC, Kosinska M, Schmidt T, Anan HH, Arifi F, Yam A, Rasanathan K, Aseffa A, Nguyen PN, Kato M, Garg A, Dorji T, Villalobos A, Haldane V, Nguyen T, Briand S. A global research agenda on public health and social measures during emergencies. Bull World Health Organ 2023; 101:717-722. [PMID: 37961059 PMCID: PMC10630736 DOI: 10.2471/blt.23.289959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 09/02/2023] [Accepted: 09/10/2023] [Indexed: 11/15/2023] Open
Abstract
The importance of strong coordination for research on public health and social measures was highlighted at the Seventy-fourth World Health Assembly in 2021. This article describes efforts undertaken by the World Health Organization (WHO) to develop a global research agenda on the use of public health and social measures during health emergencies. This work includes a multistep process that started with a global technical consultation convened by WHO in September 2021. The consultation included experts from around the world and from a wide range of disciplines, such as public health, education, tourism, finance and social sciences, and aimed to identify research and implementation approaches based on lessons learnt during the coronavirus disease 2019 pandemic. To prepare for future epidemics and pandemics, it is essential to adopt a more robust, comparable and systematic research approach to public health and social measures. Such comprehensive approach will better inform agile, balanced and context-specific implementation decisions during future emergencies. This article describes the methods used to develop global research priorities for public health and social measures and the next steps needed.
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Affiliation(s)
- Ramona Ludolph
- Epidemic and Pandemic Preparedness and Prevention Department, WHO Health Emergencies Programme, World Health Organization, 20 Avenue Appia, 1211Geneva, Switzerland
| | - Ryoko Takahashi
- Epidemic and Pandemic Preparedness and Prevention Department, WHO Health Emergencies Programme, World Health Organization, 20 Avenue Appia, 1211Geneva, Switzerland
| | - Zubin Cyrus Shroff
- Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland
| | - Monika Kosinska
- Department of Social Determinants of Health, World Health Organization, Geneva, Switzerland
| | - Tanja Schmidt
- WHO Health Emergencies Programme, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Huda Haidar Anan
- WHO Health Emergencies Programme, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Fatima Arifi
- WHO Health Emergencies Programme, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Abdoulaye Yam
- Emergency Preparedness and Response Cluster, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Kumanan Rasanathan
- Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland
| | - Abraham Aseffa
- The Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Phuong Nam Nguyen
- WHO Health Emergencies Programme, World Health Organization Regional Office for the Western Pacific, Manila, Philippines
| | - Masaya Kato
- WHO Health Emergencies Programme, World Health Organization Regional Office for South-East Asia, New Delhi, India
| | - Aarti Garg
- WHO Health Emergencies Programme, World Health Organization Regional Office for South-East Asia, New Delhi, India
| | - Tshewang Dorji
- WHO Health Emergencies Programme, World Health Organization Regional Office for South-East Asia, New Delhi, India
| | - Andrea Villalobos
- Public Health Emergencies, Pan American Health Organization, Washington, DC, United States of America
| | - Victoria Haldane
- Epidemic and Pandemic Preparedness and Prevention Department, WHO Health Emergencies Programme, World Health Organization, 20 Avenue Appia, 1211Geneva, Switzerland
| | - Tim Nguyen
- Epidemic and Pandemic Preparedness and Prevention Department, WHO Health Emergencies Programme, World Health Organization, 20 Avenue Appia, 1211Geneva, Switzerland
| | - Sylvie Briand
- Epidemic and Pandemic Preparedness and Prevention Department, WHO Health Emergencies Programme, World Health Organization, 20 Avenue Appia, 1211Geneva, Switzerland
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Xu J, Wang Z, Moghadas SM. Modelling the effect of travel-related policies on disease control in a meta-population structure. J Math Biol 2023; 87:55. [PMID: 37688625 DOI: 10.1007/s00285-023-01990-w] [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: 12/09/2022] [Revised: 06/15/2023] [Accepted: 08/22/2023] [Indexed: 09/11/2023]
Abstract
Travel restrictions, while delaying the spread of an emerging disease from the source, could inflict substantial socioeconomic burden. Travel-related policies, such as quarantine and testing of travelers, may be considered as alternative strategies to mitigate the negative impact of travel bans. We developed a meta-population, delay-differential model to evaluate a strategy that combines testing of travelers prior to departure from the source of infection with quarantine and testing at exit from quarantine in the destination population. Our results, based on early parameter estimates of SARS-CoV-2 infection, indicate that testing travelers at exit from quarantine is more effective in delaying case importation than testing them before departure or upon arrival. We show that a 1-day quarantine with an exit test could outperform a longer, 3-day quarantine without testing in delaying the outbreak peak. Rapid, large-scale testing capacities with short turnaround times provide important means of detecting infectious cases and reducing case importation, while shortening quarantine duration for travelers at destination.
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Affiliation(s)
- Jingjing Xu
- Agent-Based Modelling Laboratory, York University, 4700 Keele St., Toronto, ON, M3J 1P3, Canada
| | - Zhen Wang
- Agent-Based Modelling Laboratory, York University, 4700 Keele St., Toronto, ON, M3J 1P3, Canada
| | - Seyed M Moghadas
- Agent-Based Modelling Laboratory, York University, 4700 Keele St., Toronto, ON, M3J 1P3, Canada.
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Itzkowitz E, Alpert EA, Farojeh AZ, Zimmerman DR, Schwartz E, Lachish T. Morbidity of Returning Travelers Seen in Community Urgent Care Centers throughout Israel. Trop Med Infect Dis 2023; 8:319. [PMID: 37368737 DOI: 10.3390/tropicalmed8060319] [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: 04/20/2023] [Revised: 06/02/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
Information regarding post-travel morbidity is usually reported via dedicated post-travel clinics and mainly relates to travelers returning from low-middle-income countries (LMIC), however, the spectrum of morbidity seen within the community setting is scarcely reported. This prospective observational study among visitors to 17 community Urgent Care Centers (UCC) was designed to evaluate the reasons for post-travel community clinic visits and to compare travelers returning from LMIC to high-income countries (HIC). All visitors within one-month post-travel to all destinations were included. A total of 1580 post-travel visits were analyzed during 25 months. Travelers to LMICs were younger (mean 36.8 years old vs. 41.4 in the HIC group) and stayed longer periods abroad (30.1 ± 41.2 vs. 10.0 ± 10.6 in the HIC group) but more of them had pre-travel vaccines (35.5% vs. 6.6%). Travel-related morbidity was significantly more common in the LMIC group 58.3% (253/434) vs. 34.1% (391/1146) in the HIC group, (p < 0.001). Acute diarrhea was the leading cause of morbidity after visiting LMIC (28.8%) and was significantly more common than in the HIC (6.6%, p < 0.001). Other common morbidities in the LMIC cohort were respiratory (23.3%), cutaneous (15.8%), and injuries (9.9%). In the HIC group, the common morbidities were respiratory (37.3%), and diarrhea composed only 6.6% of the complaints. Our study group represents a less biased sample of travelers to LMIC as well as HIC, therefore, data from the UCC setting and at the specialized travel clinics complete each other in understanding the true extent of morbidity in travelers.
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Affiliation(s)
- Eyal Itzkowitz
- Nephrology Unit, Shaare Zedek Medical Center, Jerusalem 9103102, Israel
| | - Evan A Alpert
- Department of Emergency Medicine, Shaare Zedek Medical Center, Jerusalem 9103102, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9101001, Israel
| | | | - Deena R Zimmerman
- TEREM Urgent Care Centers, Jerusalem 9439029, Israel
- Maternal Child and Adolescent Department, Public Health Division, Israel Ministry of Health, Jerusalem 9446724, Israel
| | - Eli Schwartz
- The Center for Geographic Medicine and Tropical Diseases, The Chaim Sheba Medical Center, Tel Hashomer 5262000, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel
| | - Tamar Lachish
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9101001, Israel
- The Infectious Diseases Unit, Shaare Zedek Medical Center, Jerusalem 9103102, Israel
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Llamas-Clark EF, Heralde FM, Lumandas MU, Cagayan MSFS, Villanueva-Uy MET, Chavez-Coloma LC, Valencia EI, Cabana CAS, Espinosa LBH, Anzures CU, Andal MLD, Martin CPC, Suarez PNV, Quanico CD, Beltran JB, de Guzman VD, Capitulo RB, Dominguez AR, Recio AL, Feliciano JF, Baja ES, Rosell-Ubial PJB. Factors associated with having COVID-19 among unvaccinated pregnant and non-pregnant women in Metro Manila, Philippines: a multicentre longitudinal cohort study. BMJ Open 2023; 13:e070688. [PMID: 37068908 PMCID: PMC10111183 DOI: 10.1136/bmjopen-2022-070688] [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] [Indexed: 04/19/2023] Open
Abstract
OBJECTIVE To determine the potential risk factors associated with having COVID-19 among unvaccinated pregnant and non-pregnant women. DESIGN A multicentre prospective cohort study among eligible women in Metro Manila, Philippines, from 2020 to 2022. SETTING Five national and local hospital research sites altogether recruited and screened 500 consenting eligible individuals. PARTICIPANTS Pregnant and non-pregnant participants meeting the eligibility criteria were admitted for a reverse-transcription PCR determination of SARS-CoV-2, pregnancy testing and ultrasound, and an interview with an administered questionnaire. EXPOSURES Primary exposure was pregnancy; secondary exposures involve sociodemographic, lifestyle and obstetric-gynaecologic factors. OUTCOME MEASURE Outcome being measured was COVID-19 status. RESULTS The significant COVID-19 risk factors were: pregnancy (PR=1.184, 95% CI 1.096, 1.279), having a white-collar job (PR=1.123, 95% CI 1.02, 1.235), travelling abroad (PR=1.369, 95% CI 1.083, 1.173) and being infected by at least one vaccine-preventable disease (VPD) (PR=1.208, 95% CI 1.113, 1.310). Protective factors included having graduate-level education (PR=0.787, 95% CI 0.649, 0.954), immunisation against a VPD (PR=0.795, 95% CI 0.733, 0.862) and practising contraception (PR=0.889, 95% CI 0.824, 0.960). CONCLUSION This study is the first in the country to determine the risks influencing COVID-19 infection among unvaccinated pregnant and non-pregnant women. Pregnancy is a significant risk for COVID-19 among women in Metro Manila. Educational attainment and positive health behaviours seem to confer protection. Occupations and activities that increase the frequency of interactions, as well as history of communicable diseases may predispose women to COVID-19. Further studies are needed to elucidate the development of the disease in pregnant women, including the maternal and neonatal effects of COVID-19 via potential vertical mechanisms of transmission.
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Affiliation(s)
- Erlidia F Llamas-Clark
- Department of Obstetrics and Gynecology, University of the Philippines Manila College of Medicine, Manila, Philippines
- Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | - Francisco M Heralde
- Department of Molecular Biology and Biochemistry, University of the Philippines Manila College of Medicine, Manila, Philippines
| | - Mayan U Lumandas
- Department of Virology, Research Institute for Tropical Medicine, Muntinlupa, Philippines
| | - Maria Stephanie Fay S Cagayan
- Department of Pharmacology and Toxicology, University of the Philippines Manila College of Medicine, Manila, Philippines
| | - Maria Esterlita T Villanueva-Uy
- Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | - Leilani C Chavez-Coloma
- Department of Obstetrics and Gynecology, Jose R Reyes Memorial Medical Center, Manila, Philippines
| | - Eleyneth I Valencia
- Department of Obstetrics and Gynecology, Jose R Reyes Memorial Medical Center, Manila, Philippines
| | - Charizze Anne S Cabana
- Department of Obstetrics and Gynecology, Jose R Reyes Memorial Medical Center, Manila, Philippines
| | | | - Cynthia U Anzures
- Department of Obstetrics and Gynecology, Dr Jose Fabella Memorial Hospital, Manila, Philippines
| | - Maria Lu D Andal
- Department of Obstetrics and Gynecology, Dr Jose Fabella Memorial Hospital, Manila, Philippines
| | | | | | - Celine D Quanico
- Department of Obstetrics and Gynecology, Ospital ng Maynila Medical Center, Manila, Philippines
| | - Julia B Beltran
- Department of Obstetrics and Gynecology, Ospital ng Maynila Medical Center, Manila, Philippines
| | - Vanessa D de Guzman
- Department of Obstetrics and Gynecology, Justice Jose Abad Santos General Hospital, Manila, Philippines
| | - Ryan B Capitulo
- Department of Obstetrics and Gynecology, Justice Jose Abad Santos General Hospital, Manila, Philippines
| | - Arlene R Dominguez
- Department of Obstetrics and Gynecology, Sta Ana Hospital, Manila, Philippines
| | - Abygail L Recio
- Department of Obstetrics and Gynecology, Sta Ana Hospital, Manila, Philippines
| | | | - Emmanuel S Baja
- Institute of Clinical Epidemiology, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
- Department of Clinical Epidemiology, University of the Philippines Manila College of Medicine, Manila, Philippines
| | - Paulyn Jean B Rosell-Ubial
- Department of Health Policy and Administration, University of the Philippines Manila College of Public Health, Manila, Philippines
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9
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Lou J, Lim NWH, Cai CGX, Dickens BSL, Huynh VA, Wee HL. Cost benefit analysis of alternative testing and quarantine policies for travelers for infection control: A case study of Singapore during the COVID-19 pandemic. Front Public Health 2023; 11:1101986. [PMID: 36908469 PMCID: PMC9996245 DOI: 10.3389/fpubh.2023.1101986] [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: 11/18/2022] [Accepted: 01/23/2023] [Indexed: 02/25/2023] Open
Abstract
Background Border control mitigates local infections but bears a heavy economic cost, especially for tourism-reliant countries. While studies have supported the efficacy of border control in suppressing cross-border transmission, the trade-off between costs from imported and secondary cases and from lost economic activities has not been studied. This case study of Singapore during the COVID-19 pandemic aims to understand the impacts of varying quarantine length and testing strategies on the economy and health system. Additionally, we explored the impact of permitting unvaccinated travelers to address emerging equity concerns. We assumed that community transmission is stable and vaccination rates are high enough that inbound travelers are not dissuaded from traveling. Methods The number of travelers was predicted considering that longer quarantine reduces willingness to travel. A micro-simulation model predicted the number of COVID-19 cases among travelers, the resultant secondary cases, and the probability of being symptomatic in each group. The incremental net monetary benefit (INB) of Singapore was quantified under each border-opening policy compared to pre-opening status, based on tourism receipts, cost/profit from testing and quarantine, and cost and health loss due to COVID-19 cases. Results Compared to polymerase chain reaction (PCR), rapid antigen test (ART) detects fewer imported cases but results in fewer secondary cases. Longer quarantine results in fewer cases but lower INB due to reduced tourism receipts. Assuming the proportion of unvaccinated travelers is small (8% locally and 24% globally), allowing unvaccinated travelers will accrue higher INB without exceeding the intensive care unit (ICU) capacity. The highest monthly INB from all travelers is $2,236.24 m, with 46.69 ICU cases per month, achieved with ARTs at pre-departure and on arrival without quarantine. The optimal policy in terms of highest INB is robust under changes to various model assumptions. Among all cost-benefit components, the top driver for INB is tourism receipts. Conclusions With high vaccination rates locally and globally alongside stable community transmission, opening borders to travelers regardless of vaccination status will increase economic growth in the destination country. The caseloads remain manageable without exceeding ICU capacity, and costs of cases are offset by the economic value generated from travelers.
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Affiliation(s)
- Jing Lou
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Nigel Wei-Han Lim
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | | | - Borame Sue Lee Dickens
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Vinh Anh Huynh
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Hwee-Lin Wee
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore
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10
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Liddelow C, Hitchcock CS, Mullan BA. Exploring quality of life in Australian adults during a pandemic. CURRENT PSYCHOLOGY 2022; 42:1-13. [PMID: 36406856 PMCID: PMC9647751 DOI: 10.1007/s12144-022-03831-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 11/11/2022]
Abstract
Many aspects of society changed due to the COVID-19 pandemic. As a result, many individuals experienced the introduction of travel bans and restrictions, COVID-19 related anxiety, greater risk to their health and an increased need for adaptive coping. Research has shown health-related quality of life was negatively affected during the time. However, the influence that these restrictions and experiences had on other various quality of life domains (physical, psychological, environmental, and social) is not yet known. Therefore, we aimed to examine the relationships between COVID-19-related variables, health variables, psychological variables and five domains of quality of life in Australian adults. Data was collected via cross-sectional online surveys from 264 Australian participants (M age = 29.76 years, SD = 12.40). Five hierarchical multiple regression analyses were conducted. The findings showed better adaptive coping, decreased COVID-19 anxiety, and lower perceived health risk were all associated with better quality of life during this time. Neither having travel plans during 2020-2021 nor engaging in compensatory behaviours were associated with quality of life. During times of uncertainty, such as pandemics, natural disasters or war, providing anxiety-reducing coping strategies may be beneficial for reducing the negative impacts on quality of life. In line with these findings and similar research, we have provided several directions and recommendations for governments and media organisations for when future events, similar to COVID-19, occur.
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Affiliation(s)
- Caitlin Liddelow
- Global Alliance for Mental Health and Sport, School of Psychology, University of Wollongong, 2500 AUS Wollongong, NSW Australia
| | | | - Barbara A Mullan
- EnAble Institute, Curtin University, 6102 AUS Perth, WA Australia
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11
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Oster C, Ali K, Iasiello M, Muir-Cochrane E, Fassnacht DB. The experience of individuals affected by Australia's international border closure during the COVID-19 pandemic. Health Place 2022; 78:102928. [PMID: 36279757 PMCID: PMC9576689 DOI: 10.1016/j.healthplace.2022.102928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 08/16/2022] [Accepted: 10/13/2022] [Indexed: 11/27/2022]
Abstract
This study explored the experiences of individuals who reported being negatively affected by Australia's international border closure during the COVID-19 pandemic. Qualitative data from 1930 adults who responded to a cross-sectional online survey exploring the mental health and wellbeing of individuals affected by border closure were analysed using theoretical thematic analysis, drawing on understandings of the relationship between place and wellbeing. Four themes were identified: 'Disconnection from family and social connections', 'Disconnection from a sense of home and belonging', 'Disconnection and sense of self', and 'A desire for reconnection'. Results provide a rich illustration of the relationship between disconnection from place and wellbeing during COVID-19 and highlight the need to support those affected and consider these adverse effects in future public health planning.
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Affiliation(s)
- Candice Oster
- College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, South Australia, 5042, Australia,College of Nursing and Health Science, Flinders University, Sturt Road, Bedford Park, South Australia, 5042, Australia,Corresponding author. College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, South Australia, 5042, Australia
| | - Kathina Ali
- College of Education, Psychology and Social Work, Flinders University, Sturt Road, Bedford Park, South Australia, 5042, Australia,Órama Institute for Mental Health & Wellbeing, Flinders University, Sturt Road, Bedford Park, South Australia, 5042, Australia
| | - Matthew Iasiello
- Wellbeing and Resilience Centre, Lifelong Health Theme, South Australian Health and Medical Research Institute, North Terrace, Adelaide, South Australia, 5000, Australia,College of Nursing and Health Science, Flinders University, Sturt Road, Bedford Park, South Australia, 5042, Australia
| | - Eimear Muir-Cochrane
- College of Nursing and Health Science, Flinders University, Sturt Road, Bedford Park, South Australia, 5042, Australia
| | - Daniel B. Fassnacht
- College of Education, Psychology and Social Work, Flinders University, Sturt Road, Bedford Park, South Australia, 5042, Australia,Órama Institute for Mental Health & Wellbeing, Flinders University, Sturt Road, Bedford Park, South Australia, 5042, Australia
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12
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Travel in the Time of COVID: A Review of International Travel Health in a Global Pandemic. Curr Infect Dis Rep 2022; 24:129-145. [PMID: 35965881 PMCID: PMC9361911 DOI: 10.1007/s11908-022-00784-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2022] [Indexed: 11/03/2022]
Abstract
Abstract
Purpose of Review
This review critically considers the impact of the COVID-19 pandemic on global travel and the practice of travel medicine, highlights key innovations that have facilitated the resumption of travel, and anticipates how travel medicine providers should prepare for the future of international travel.
Recent Findings
Since asymptomatic transmission of the virus was first recognized in March 2020, extensive efforts have been made to characterize the pattern and dynamics of SARS-CoV-2 transmission aboard commercial aircraft, cruise ships, rail and bus transport, and in mass gatherings and quarantine facilities. Despite the negative impact of further waves of COVID-19 driven by the more transmissible Omicron variant, rapid increases of international tourist arrivals are occurring and modeling anticipates further growth. Mitigation of spread requires an integrated approach that combines masking, physical distancing, improving ventilation, testing, and quarantine. Vaccines and therapeutics have played a significant role in reopening society and accelerating the resumption of travel and further therapeutic innovation is likely.
Summary
COVID-19 is likely to persist as an endemic infection, and surveillance will assume an even more important role. The pandemic has provided an impetus to advance technology for telemedicine, to adopt mobile devices and GPS in contact tracing, and to apply digital applications in research. The future of travel medicine should continue to harness these novel platforms in the clinical, research, and educational arenas.
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13
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Rehfuess EA, Burns JB, Pfadenhauer LM, Krishnaratne S, Littlecott H, Meerpohl JJ, Movsisyan A. Lessons learnt: Undertaking rapid reviews on public health and social measures during a global pandemic. Res Synth Methods 2022; 13:558-572. [PMID: 35704478 PMCID: PMC9349463 DOI: 10.1002/jrsm.1580] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 06/01/2022] [Accepted: 06/10/2022] [Indexed: 12/04/2022]
Abstract
Public health and social measures (PHSM) have been central to the COVID‐19 response. Consequently, there has been much pressure on decision‐makers to make evidence‐informed decisions and on researchers to synthesize the evidence regarding these measures. This article describes our experiences, responses and lessons learnt regarding key challenges when planning and conducting rapid reviews of PHSM during the COVID‐19 pandemic. Stakeholder consultations and scoping reviews to obtain an overview of the evidence inform the scope of reviews that are policy‐relevant and feasible. Multiple complementary reviews serve to examine the benefits and harms of PHSM across different populations and contexts. Conceiving reviews of effectiveness as adaptable living reviews helps to respond to evolving evidence needs and an expanding evidence base. An appropriately skilled review team and good planning, coordination and communication ensures smooth and rigorous processes and efficient use of resources. Scientific rigor, the practical implications of PHSM‐related complexity and likely time savings should be carefully weighed in deciding on methodological shortcuts. Making the best possible use of modeling studies represents a particular challenge, and methods should be carefully chosen, piloted and implemented. Our experience raises questions regarding the nature of rapid reviews and regarding how different types of evidence should be considered in making decisions about PHSM during a global pandemic. We highlight the need for readily available protocols for conducting studies on the effectiveness, unintended consequences and implementation of PHSM in a timely manner, as well as the need for rapid review standards tailored to “rapid” versus “emergency” mode reviewing.
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Affiliation(s)
- E A Rehfuess
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität, Munich, Germany.,Pettenkofer School of Public Health, Munich, Germany
| | - J B Burns
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität, Munich, Germany.,Pettenkofer School of Public Health, Munich, Germany
| | - L M Pfadenhauer
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität, Munich, Germany.,Pettenkofer School of Public Health, Munich, Germany
| | - S Krishnaratne
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität, Munich, Germany.,Pettenkofer School of Public Health, Munich, Germany.,Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - H Littlecott
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität, Munich, Germany.,Pettenkofer School of Public Health, Munich, Germany.,DECIPHer (Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement), School of Social Sciences, Cardiff University, Cardiff, United Kingdom
| | - J J Meerpohl
- Institute for Evidence in Medicine, Medical Center & Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Cochrane Germany, Cochrane Germany Foundation, Freiburg, Germany
| | - A Movsisyan
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität, Munich, Germany.,Pettenkofer School of Public Health, Munich, Germany
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14
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Subedee KC, Paudel KP, Khogali M, Pokhrel A, Chinnakali P, Thakur N, Timsina D, Gautam R, Rahman A, Mandal SK, Adhikari MD, Harries AD. COVID-19 Amongst Travelers at Points of Entry in Nepal: Screening, Testing, Diagnosis and Isolation Practices. Trop Med Infect Dis 2022; 7:tropicalmed7060099. [PMID: 35736978 PMCID: PMC9230935 DOI: 10.3390/tropicalmed7060099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 06/04/2022] [Accepted: 06/08/2022] [Indexed: 02/01/2023] Open
Abstract
WHO recommends surveillance for COVID-19 among travelers at Points of Entry (POE) to countries. At 13 selected POE at the Nepal-India border, between March 2021 and July 2021, we describe the screening, testing, diagnosis and isolation practices of COVID-19 amongst travelers. Those who stayed in India or elsewhere for > one day and those who did not have a negative RT-PCR result within the last 72 h of travel were tested for COVID-19 with rapid antigen diagnostic tests. Daily surveillance reports maintained at POE were used for analysis. Of 337,338 travelers screened, 69,886 (21%) were tested and 3907 (6%) were diagnosed with COVID-19. The proportions tested averaged 15% during April-May when screened numbers were high and increased to 35% in July when screened numbers had decreased. The proportions diagnosed positive peaked at 10% in April-May, but decreased to below 1% in June and July. Testing coverage varied from 0−99% in the different POE. Most COVID-19 cases were Nepalese, male, <60 years of age, migrant workers and presented with fever. Of COVID-19 cases, 32% had home-based isolation, 64% underwent community-based isolation and the remainder either went to hospital or returned to India. In conclusion, about one fifth of travelers overall were tested, with coverage varying considerably over time and among different POE. Strengthening surveillance processes at POE is needed.
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Affiliation(s)
- Koshal Chandra Subedee
- Department of Health Services, Epidemiology and Disease Control Division, Kathmandu 44600, Nepal; (A.P.); (N.T.)
- Correspondence: ; Tel.: +977-984-188-0884
| | | | - Mohammed Khogali
- Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization (WHO), 1211 Geneva, Switzerland;
| | - Amrit Pokhrel
- Department of Health Services, Epidemiology and Disease Control Division, Kathmandu 44600, Nepal; (A.P.); (N.T.)
| | - Palanivel Chinnakali
- Department of Preventive and Social Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry 605006, India;
| | - Nishant Thakur
- Department of Health Services, Epidemiology and Disease Control Division, Kathmandu 44600, Nepal; (A.P.); (N.T.)
| | | | - Rabin Gautam
- World Health Organization (WHO), Country Office, Kathmandu 44600, Nepal;
| | - Anisur Rahman
- World Health Organization (WHO), Country Office, New Delhi 110029, India;
| | | | | | - Anthony D. Harries
- International Union Against Tuberculosis and Lung Disease (The Union), 2 Rue Jean Lantier, 75001 Paris, France;
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
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15
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Ali K, Iasiello M, van Agteren J, Mavrangelos T, Kyrios M, Fassnacht DB. A cross-sectional investigation of the mental health and wellbeing among individuals who have been negatively impacted by the COVID-19 international border closure in Australia. Global Health 2022; 18:12. [PMID: 35135575 PMCID: PMC8822815 DOI: 10.1186/s12992-022-00807-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 01/18/2022] [Indexed: 01/09/2023] Open
Abstract
Background The COVID-19 pandemic resulted in the Australian government implementing strict international border closures. However, research has not yet investigated the mental health status of individuals impacted negatively by these international border closures. Methods The present study was a cross-sectional online survey of 3968 adults who reported being negatively affected by the border closure during June and July 2021. Psychological distress was measured with the Kessler Psychological Distress Scale (K10), stress with the Perceived Stress Scale (PSS) and wellbeing with the Mental Health Continuum Short Form (MHC-SF). Results In total, 3968 participants reported being negatively affected by the current restrictions (63.4% in Australia, 36.6% overseas). The vast majority of respondents (83.6%) reported high or very high levels of psychological distress (mean K10 score > 22), and 74.8% reported poor mental wellbeing, with similar risk profiles for participants in Australia or overseas. The most common scenarios of affected individuals included 1) wanting to enter Australia (30.8%), 2) wanting to leave Australia (29.6%) and 3) wanting someone to enter Australia (25.6%). Reasons included wanting to be with partners, family and friends (81.1%), for employment/economic reasons (4.9%), study (4.1%), personal safety/health (2.6%) or holiday (1.4%). While psychological distress was extremely high across all groups, separated partners and those with interrupted study experienced the highest distress (mean K10 = 35.7, n = 155). Conclusion The data suggests a highly elevated mental health risk profile among individuals who report being negatively affected by current Australian international border closures. The results provide valuable data to inform future policy decisions and have clear implications regarding effective service provision for this vulnerable group. Supplementary Information The online version contains supplementary material available at 10.1186/s12992-022-00807-7.
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Affiliation(s)
- Kathina Ali
- College of Education, Psychology and Social Work, Flinders University, Sturt Road, Bedford Park, South Australia, 5042, Australia. .,Órama Institute for Mental Health & Wellbeing, Flinders University, Sturt Road, Bedford Park, South Australia, 5042, Australia.
| | - Matthew Iasiello
- Wellbeing and Resilience Centre, Lifelong Health Theme, South Australian Health and Medical Research Institute, North Terrace, Adelaide, South Australia, 5000, Australia.,College of Nursing and Health Science, Flinders University, Sturt Road, Bedford Park, South Australia, 5042, Australia
| | - Joep van Agteren
- College of Education, Psychology and Social Work, Flinders University, Sturt Road, Bedford Park, South Australia, 5042, Australia.,Wellbeing and Resilience Centre, Lifelong Health Theme, South Australian Health and Medical Research Institute, North Terrace, Adelaide, South Australia, 5000, Australia
| | - Teri Mavrangelos
- College of Education, Psychology and Social Work, Flinders University, Sturt Road, Bedford Park, South Australia, 5042, Australia
| | - Michael Kyrios
- College of Education, Psychology and Social Work, Flinders University, Sturt Road, Bedford Park, South Australia, 5042, Australia.,Órama Institute for Mental Health & Wellbeing, Flinders University, Sturt Road, Bedford Park, South Australia, 5042, Australia
| | - Daniel B Fassnacht
- College of Education, Psychology and Social Work, Flinders University, Sturt Road, Bedford Park, South Australia, 5042, Australia.,Órama Institute for Mental Health & Wellbeing, Flinders University, Sturt Road, Bedford Park, South Australia, 5042, Australia
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16
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Budrie L, Narinesingh A. Locked out: An ethical analysis of Trinidad and Tobago's COVID-19 border closure. ETHICS, MEDICINE, AND PUBLIC HEALTH 2022; 20:100749. [PMID: 34901364 PMCID: PMC8648578 DOI: 10.1016/j.jemep.2021.100749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/29/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The COVID-19 pandemic has forced nearly every nation around the world to implement border restrictions, some of which have prevented citizens from entering their own country. Restricting access to one's own country was a burdensome intervention, but may have been necessary given the global emergency. Thus, the decision restrict citizens' entry as a public health intervention warrants ethical analysis to determine its appropriateness. The focus of this paper is on the ethics of the 15-month border closure implemented in Trinidad and Tobago during the COVID-19 pandemic. METHODOLOGY Ethical analysis of the COVID-19 border closure in Trinidad and Tobago was done using a six-part ethical framework for public health. DISCUSSION The ethical analysis highlights various areas of concern which question the justification for the border closure. The effectiveness, necessity and proportionality of the intervention were justified in the short-term, however, as benefits diminished over time, this did not result in appropriate policy changes. Continuous evaluation of the intervention throughout its use could have improved the balance of benefits and burdens thereby providing stronger ethical validation. CONCLUSION The COVID-19 border closure in Trinidad and Tobago brought substantial burdens upon its citizens without comparable benefits. Data from previous pandemics and the best available data during the current pandemic showed that effectiveness was limited to the initial months, after which it would have been unnecessary to maintain. Thus, the government's decision to prolong the border closure for 15 months, well past its time of effectiveness, was not ethically justified from our analysis.
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Affiliation(s)
- L Budrie
- Department of Microbiology, Immunology and Pharmacology, St. George's University School of Medicine, True Blue, St. George, Grenada
- Faculty of Bioethics, Anáhuac University, México
| | - A Narinesingh
- Department of Physiology, Neuroscience and Behavioural Sciences, St. George's University School of Medicine, St. George, Grenada
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17
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KC S, Faradiba D, Sittimart M, Isaranuwatchai W, Ananthakrishnan A, Rachatan C, Dabak S, Shafie AA, Guerrero AM, Suwantika A, Kang G, Ahn J, Hsu LY, Mayxay M, Howard N, Wattanasri P, Nakamura R, George TK, Teerawattananon Y. Factors associated with the opposition to COVID-19 vaccination certificates: A multi-country observational study from Asia. Travel Med Infect Dis 2022; 48:102358. [PMID: 35595199 PMCID: PMC9113761 DOI: 10.1016/j.tmaid.2022.102358] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/27/2022] [Accepted: 05/15/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND There are ongoing calls to harmonise and increase the use of COVID-19 vaccination certificates (CVCs) in Asia. Identifying groups in Asian societies who oppose CVCs and understanding their reasons can help formulate an effective CVCs policy in the region. However, no formal studies have explored this issue in Asia. METHOD The COVID-19 Vaccination Policy Research and Decision-Support Initiative in Asia (CORESIA) was established to address policy questions related to CVCs. An online cross-sectional survey was conducted from June to October 2021 in nine Asian countries. Multivariable logistical regression analyses were performed to identify potential opposers of CVCs. RESULTS Six groups were identified as potential opposers of CVCs: (i) unvaccinated (Odd Ratio (OR): 2.01, 95% Confidence Interval (CI): 1.65-2.46); vaccine hesitant and those without access to COVID-19 vaccines; (ii) those not wanting existing NPIs to continue (OR: 2.97, 95% CI: 2.51-3.53); (iii) those with low level of trust in governments (OR: 1.25, 95% CI: 1.02-2.52); (iv) those without travel plans (OR: 1.58, 95% CI: 1.31-1.90); (v) those expecting no financial gains from CVCs (OR: 2.35, 95% CI: 1.98-2.78); and (vi) those disagreeing to use CVCs for employment, education, events, hospitality, and domestic travel. CONCLUSIONS Addressing recurring public health bottlenecks such as vaccine hesitancy and equitable access, adherence to policies, public trust, and changing the narrative from 'societal-benefit' to 'personal-benefit' may be necessary and may help increase wider adoption of CVCs in Asia.
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Affiliation(s)
- Sarin KC
- Health Intervention and Technology Assessment Program (HITAP), 6th Floor, 6th Building, Department of Health, Ministry of Public Health, Tiwanon Road, Nonthaburi, 11000, Thailand
| | - Dian Faradiba
- Health Intervention and Technology Assessment Program (HITAP), 6th Floor, 6th Building, Department of Health, Ministry of Public Health, Tiwanon Road, Nonthaburi, 11000, Thailand
| | - Manit Sittimart
- Health Intervention and Technology Assessment Program (HITAP), 6th Floor, 6th Building, Department of Health, Ministry of Public Health, Tiwanon Road, Nonthaburi, 11000, Thailand,Corresponding author
| | - Wanrudee Isaranuwatchai
- Health Intervention and Technology Assessment Program (HITAP), 6th Floor, 6th Building, Department of Health, Ministry of Public Health, Tiwanon Road, Nonthaburi, 11000, Thailand,Institute of Health Policy, Management and Evaluation, St. Michael's Hospital, University of Toronto, 30 Bond St Toronto, ON M5B 1W8, Canada
| | - Aparna Ananthakrishnan
- Health Intervention and Technology Assessment Program (HITAP), 6th Floor, 6th Building, Department of Health, Ministry of Public Health, Tiwanon Road, Nonthaburi, 11000, Thailand
| | - Chayapat Rachatan
- Health Intervention and Technology Assessment Program (HITAP), 6th Floor, 6th Building, Department of Health, Ministry of Public Health, Tiwanon Road, Nonthaburi, 11000, Thailand
| | - Saudamini Dabak
- Health Intervention and Technology Assessment Program (HITAP), 6th Floor, 6th Building, Department of Health, Ministry of Public Health, Tiwanon Road, Nonthaburi, 11000, Thailand
| | - Asrul Akmal Shafie
- School of Pharmaceutical Sciences, 11800, Universiti Sains Malaysia, Pulau Pinang, Malaysia
| | | | - Auliya Suwantika
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jl. Raya Bandung-Sumedang Km. 21 Jatinangor, Sumedang, 45363, West Java, Indonesia
| | - Gagandeep Kang
- Division of Gastrointestinal Sciences, The Christian Medical College (CMC), IDA Scudder Rd, Vellore, Tamil Nadu, 632004, India
| | - Jeonghoon Ahn
- Department of Health Convergence, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul, 03760, Republic of Korea
| | - Li Yang Hsu
- Saw Swee Hock School of Public Health (SSHSPH), National University of Singapore (NUS), 12 Science Drive 2, #10-01, 117549, Singapore
| | - Mayfong Mayxay
- Department of Medicine, University of Health Sciences, Samsenthai Road P.O. Box 7444, Vientiane, Laos,Lao-Oxford-Mahosot Hospital-Welcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vietiane, Laos,Centre for Tropical Medicine and Global Health, University of Oxford, United Kingdom
| | - Natasha Howard
- Saw Swee Hock School of Public Health (SSHSPH), National University of Singapore (NUS), 12 Science Drive 2, #10-01, 117549, Singapore,London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT, UK
| | - Parinda Wattanasri
- Department of Disease Control, Ministry of Public Health, Tiwanon Road, Nonthaburi, 11000, Thailand
| | - Ryota Nakamura
- Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Faculty Building II, 2-1, Naka, Kunitachi, 186 - 8601, Japan
| | - Tarun K. George
- Department of General Internal Medicine, The Christian Medical College (CMC), IDA Scudder Rd, Vellore, Tamil Nadu, 632004, India
| | - Yot Teerawattananon
- Health Intervention and Technology Assessment Program (HITAP), 6th Floor, 6th Building, Department of Health, Ministry of Public Health, Tiwanon Road, Nonthaburi, 11000, Thailand,Saw Swee Hock School of Public Health (SSHSPH), National University of Singapore (NUS), 12 Science Drive 2, #10-01, 117549, Singapore
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