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Saleem S, Rafiq M, Ahmed N, Arif MS, Raza A, Iqbal Z, Niazai S, Khan I. Fractional epidemic model of coronavirus disease with vaccination and crowding effects. Sci Rep 2024; 14:8157. [PMID: 38589475 DOI: 10.1038/s41598-024-58192-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 03/26/2024] [Indexed: 04/10/2024] Open
Abstract
Most of the countries in the world are affected by the coronavirus epidemic that put people in danger, with many infected cases and deaths. The crowding factor plays a significant role in the transmission of coronavirus disease. On the other hand, the vaccines of the covid-19 played a decisive role in the control of coronavirus infection. In this paper, a fractional order epidemic model (SIVR) of coronavirus disease is proposed by considering the effects of crowding and vaccination because the transmission of this infection is highly influenced by these two factors. The nonlinear incidence rate with the inclusion of these effects is a better approach to understand and analyse the dynamics of the model. The positivity and boundedness of the fractional order model is ensured by applying some standard results of Mittag Leffler function and Laplace transformation. The equilibrium points are described analytically. The existence and uniqueness of the non-integer order model is also confirmed by using results of the fixed-point theory. Stability analysis is carried out for the system at both the steady states by using Jacobian matrix theory, Routh-Hurwitz criterion and Volterra-type Lyapunov functions. Basic reproductive number is calculated by using next generation matrix. It is verified that disease-free equilibrium is locally asymptotically stable ifR 0 < 1 and endemic equilibrium is locally asymptotically stable ifR 0 > 1 . Moreover, the disease-free equilibrium is globally asymptotically stable ifR 0 < 1 and endemic equilibrium is globally asymptotically stable ifR 0 > 1 . The non-standard finite difference (NSFD) scheme is developed to approximate the solutions of the system. The simulated graphs are presented to show the key features of the NSFD approach. It is proved that non-standard finite difference approach preserves the positivity and boundedness properties of model. The simulated graphs show that the implementation of control strategies reduced the infected population and increase the recovered population. The impact of fractional order parameter α is described by the graphical templates. The future trends of the virus transmission are predicted under some control measures. The current work will be a value addition in the literature. The article is closed by some useful concluding remarks.
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Affiliation(s)
- Suhail Saleem
- Department of Mathematics, Air University, PAF Complex E-9, Islamabad, 44000, Pakistan
| | - Muhammad Rafiq
- Department of Mathematics, Faculty of Science and Technology, University of Central Punjab, Lahore, Pakistan
- Department of Computer Science and Mathematics, Lebanese American University, Beirut, 1102-2801, Lebanon
| | - Nauman Ahmed
- Department of Mathematics and Statistics, The University of Lahore, Lahore, Pakistan
- Department of Computer Science and Mathematics, Lebanese American University, Beirut, 1102-2801, Lebanon
| | - Muhammad Shoaib Arif
- Department of Mathematics, Air University, PAF Complex E-9, Islamabad, 44000, Pakistan
| | - Ali Raza
- Department of Mathematics, University of Chanab, Gujrat, Pakistan
- Department of Mathematics, Mathematics Research Center, Near East University, Near East Boulevard, 99138, Nicosia/Mersin 10, Turkey
| | - Zafar Iqbal
- Department of Mathematics and Statistics, The University of Lahore, Lahore, Pakistan
| | - Shafiullah Niazai
- Department of Mathematics, Education Faculty, Laghman University, Mehtarlam City, 2701, Laghman, Afghanistan.
| | - Ilyas Khan
- Department of Mathematics, College of Science Al-Zulfi Majmaah University, 11952, Al-Majmaah, Saudi Arabia.
- Department of Mathematics, Saveetha School of Engineering, SIMATS, Chennai, Tamil Nadu, India.
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Simmonds EG, Adjei KP, Cretois B, Dickel L, González-Gil R, Laverick JH, Mandeville CP, Mandeville EG, Ovaskainen O, Sicacha-Parada J, Skarstein ES, O'Hara B. Recommendations for quantitative uncertainty consideration in ecology and evolution. Trends Ecol Evol 2024; 39:328-337. [PMID: 38030538 DOI: 10.1016/j.tree.2023.10.012] [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: 06/17/2023] [Revised: 09/13/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023]
Abstract
Ecological and evolutionary studies are currently failing to achieve complete and consistent reporting of model-related uncertainty. We identify three key barriers - a focus on parameter-related uncertainty, obscure uncertainty metrics, and limited recognition of uncertainty propagation - which have led to gaps in uncertainty consideration. However, these gaps can be closed. We propose that uncertainty reporting in ecology and evolution can be improved through wider application of existing statistical solutions and by adopting good practice from other scientific fields. Our recommendations include greater consideration of input data and model structure uncertainties, field-specific uncertainty standards for methods and reporting, and increased uncertainty propagation through the use of hierarchical models.
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Affiliation(s)
- Emily G Simmonds
- The Centre for Biodiversity Dynamics, Norwegian University of Science and Technology, Trondheim 7491, Norway; Institute for Biology, Norwegian University of Science and Technology, Trondheim 7491, Norway; Institute of Ecology and Evolution, School of Biological Sciences, University of Edinburgh, Edinburgh EH9 3FL, UK.
| | - Kwaku P Adjei
- The Centre for Biodiversity Dynamics, Norwegian University of Science and Technology, Trondheim 7491, Norway; Department of Mathematical Sciences, Norwegian University of Science and Technology, Trondheim 7034, Norway
| | - Benjamin Cretois
- Norwegian Institute for Nature Research, Torgarden, Trondheim, Trøndelag 7485, Norway
| | - Lisa Dickel
- The Centre for Biodiversity Dynamics, Norwegian University of Science and Technology, Trondheim 7491, Norway; Institute for Biology, Norwegian University of Science and Technology, Trondheim 7491, Norway
| | - Ricardo González-Gil
- Observatorio Marino de Asturias (OMA), Departamento de Biología de Organismos y Sistemas, University of Oviedo, 33071 Oviedo, Spain; GOAL, Colonia Castaño Sur, Casa 1901, Calle Paseo Virgilio Zelaya Rubí, Tegucigalpa, Honduras, CA, USA
| | - Jack H Laverick
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow G1 1XH, UK
| | - Caitlin P Mandeville
- The Centre for Biodiversity Dynamics, Norwegian University of Science and Technology, Trondheim 7491, Norway; Department of Natural History, Norwegian University of Science and Technology, Trondheim, Trøndelag 7491, Norway
| | | | - Otso Ovaskainen
- The Centre for Biodiversity Dynamics, Norwegian University of Science and Technology, Trondheim 7491, Norway; Organismal and Evolutionary Biology Research Programme, University of Helsinki, Helsinki 00014, Finland; Department of Biological and Environmental Science, University of Jyväskylä, Jyväskylä 40014, Finland
| | - Jorge Sicacha-Parada
- Department of Mathematical Sciences, Norwegian University of Science and Technology, Trondheim 7034, Norway
| | - Emma S Skarstein
- Department of Mathematical Sciences, Norwegian University of Science and Technology, Trondheim 7034, Norway
| | - Bob O'Hara
- The Centre for Biodiversity Dynamics, Norwegian University of Science and Technology, Trondheim 7491, Norway; Department of Mathematical Sciences, Norwegian University of Science and Technology, Trondheim 7034, Norway
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Zitzmann C, Ke R, Ribeiro RM, Perelson AS. How robust are estimates of key parameters in standard viral dynamic models? PLoS Comput Biol 2024; 20:e1011437. [PMID: 38626190 PMCID: PMC11051641 DOI: 10.1371/journal.pcbi.1011437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 04/26/2024] [Accepted: 04/01/2024] [Indexed: 04/18/2024] Open
Abstract
Mathematical models of viral infection have been developed, fitted to data, and provide insight into disease pathogenesis for multiple agents that cause chronic infection, including HIV, hepatitis C, and B virus. However, for agents that cause acute infections or during the acute stage of agents that cause chronic infections, viral load data are often collected after symptoms develop, usually around or after the peak viral load. Consequently, we frequently lack data in the initial phase of viral growth, i.e., when pre-symptomatic transmission events occur. Missing data may make estimating the time of infection, the infectious period, and parameters in viral dynamic models, such as the cell infection rate, difficult. However, having extra information, such as the average time to peak viral load, may improve the robustness of the estimation. Here, we evaluated the robustness of estimates of key model parameters when viral load data prior to the viral load peak is missing, when we know the values of some parameters and/or the time from infection to peak viral load. Although estimates of the time of infection are sensitive to the quality and amount of available data, particularly pre-peak, other parameters important in understanding disease pathogenesis, such as the loss rate of infected cells, are less sensitive. Viral infectivity and the viral production rate are key parameters affecting the robustness of data fits. Fixing their values to literature values can help estimate the remaining model parameters when pre-peak data is missing or limited. We find a lack of data in the pre-peak growth phase underestimates the time to peak viral load by several days, leading to a shorter predicted growth phase. On the other hand, knowing the time of infection (e.g., from epidemiological data) and fixing it results in good estimates of dynamical parameters even in the absence of early data. While we provide ways to approximate model parameters in the absence of early viral load data, our results also suggest that these data, when available, are needed to estimate model parameters more precisely.
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Affiliation(s)
- Carolin Zitzmann
- Theoretical Biology and Biophysics Group, Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico
| | - Ruian Ke
- Theoretical Biology and Biophysics Group, Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico
| | - Ruy M. Ribeiro
- Theoretical Biology and Biophysics Group, Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico
| | - Alan S. Perelson
- Theoretical Biology and Biophysics Group, Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico
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Ofori SK, Dankwa EA, Ngwakongnwi E, Amberbir A, Bekele A, Murray MB, Grad YH, Buckee CO, Hedt-Gauthier BL. Evidence-based Decision Making: Infectious Disease Modeling Training for Policymakers in East Africa. Ann Glob Health 2024; 90:22. [PMID: 38523847 PMCID: PMC10959131 DOI: 10.5334/aogh.4383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/17/2024] [Indexed: 03/26/2024] Open
Abstract
Background Mathematical modeling of infectious diseases is an important decision-making tool for outbreak control. However, in Africa, limited expertise reduces the use and impact of these tools on policy. Therefore, there is a need to build capacity in Africa for the use of mathematical modeling to inform policy. Here we describe our experience implementing a mathematical modeling training program for public health professionals in East Africa. Methods We used a deliverable-driven and learning-by-doing model to introduce trainees to the mathematical modeling of infectious diseases. The training comprised two two-week in-person sessions and a practicum where trainees received intensive mentorship. Trainees evaluated the content and structure of the course at the end of each week, and this feedback informed the strategy for subsequent weeks. Findings Out of 875 applications from 38 countries, we selected ten trainees from three countries - Rwanda (6), Kenya (2), and Uganda (2) - with guidance from an advisory committee. Nine trainees were based at government institutions and one at an academic organization. Participants gained skills in developing models to answer questions of interest and critically appraising modeling studies. At the end of the training, trainees prepared policy briefs summarizing their modeling study findings. These were presented at a dissemination event to policymakers, researchers, and program managers. All trainees indicated they would recommend the course to colleagues and rated the quality of the training with a median score of 9/10. Conclusions Mathematical modeling training programs for public health professionals in Africa can be an effective tool for research capacity building and policy support to mitigate infectious disease burden and forecast resources. Overall, the course was successful, owing to a combination of factors, including institutional support, trainees' commitment, intensive mentorship, a diverse trainee pool, and regular evaluations.
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Affiliation(s)
- Sylvia K. Ofori
- Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Emmanuelle A. Dankwa
- Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Emmanuel Ngwakongnwi
- Institute of Global Health Equity Research, University of Global Health Equity, Kigali, Rwanda
| | - Alemayehu Amberbir
- Institute of Global Health Equity Research, University of Global Health Equity, Kigali, Rwanda
| | - Abebe Bekele
- School of Medicine, University of Global Health Equity, Kigali, Rwanda
| | - Megan B. Murray
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Yonatan H. Grad
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Caroline O. Buckee
- Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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How modelling can better support public health policy making: the Lancet Commission on Strengthening the Use of Epidemiological Modelling of Emerging and Pandemic Infectious Diseases. Lancet 2024; 403:789-791. [PMID: 38141627 DOI: 10.1016/s0140-6736(23)02758-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 12/06/2023] [Indexed: 12/25/2023]
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Hrzic R, Cade MV, Wong BLH, McCreesh N, Simon J, Czabanowska K. A competency framework on simulation modelling-supported decision-making for Master of Public Health graduates. J Public Health (Oxf) 2024; 46:127-135. [PMID: 38061776 PMCID: PMC10901273 DOI: 10.1093/pubmed/fdad248] [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: 07/10/2023] [Revised: 10/04/2023] [Accepted: 11/09/2023] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Simulation models are increasingly important for supporting decision-making in public health. However, due to lack of training, many public health professionals remain unfamiliar with constructing simulation models and using their outputs for decision-making. This study contributes to filling this gap by developing a competency framework on simulation model-supported decision-making targeting Master of Public Health education. METHODS The study combined a literature review, a two-stage online Delphi survey and an online consensus workshop. A draft competency framework was developed based on 28 peer-reviewed publications. A two-stage online Delphi survey involving 15 experts was conducted to refine the framework. Finally, an online consensus workshop, including six experts, evaluated the competency framework and discussed its implementation. RESULTS The competency framework identified 20 competencies related to stakeholder engagement, problem definition, evidence identification, participatory system mapping, model creation and calibration and the interpretation and dissemination of model results. The expert evaluation recommended differentiating professional profiles and levels of expertise and synergizing with existing course contents to support its implementation. CONCLUSIONS The competency framework developed in this study is instrumental to including simulation model-supported decision-making in public health training. Future research is required to differentiate expertise levels and develop implementation strategies.
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Affiliation(s)
- Rok Hrzic
- Department of International Health, Care and Public Health Research Institute - CAPHRI, Maastricht University, Maastricht, 6200 MD, Netherlands
| | - Maria Vitoria Cade
- Department of International Health, Care and Public Health Research Institute - CAPHRI, Maastricht University, Maastricht, 6200 MD, Netherlands
| | - Brian Li Han Wong
- Department of International Health, Care and Public Health Research Institute - CAPHRI, Maastricht University, Maastricht, 6200 MD, Netherlands
| | - Nicky McCreesh
- Department of Infectious Disease Epidemiology and Dynamics, Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Judit Simon
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, 1090, Austria
| | - Katarzyna Czabanowska
- Department of International Health, Care and Public Health Research Institute - CAPHRI, Maastricht University, Maastricht, 6200 MD, Netherlands
- Department of Health Policy Management, Institute of Public Health, Jagiellonian University, Krakow, 31-066, Poland
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Hamilton MA, Knight J, Mishra S. Examining the Influence of Imbalanced Social Contact Matrices in Epidemic Models. Am J Epidemiol 2024; 193:339-347. [PMID: 37715459 PMCID: PMC10840077 DOI: 10.1093/aje/kwad185] [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: 12/02/2022] [Revised: 06/16/2023] [Accepted: 09/12/2023] [Indexed: 09/17/2023] Open
Abstract
Transmissible infections such as those caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread according to who contacts whom. Therefore, many epidemic models incorporate contact patterns through contact matrices. Contact matrices can be generated from social contact survey data. However, the resulting matrices are often imbalanced, such that the total number of contacts reported by group A with group B do not match those reported by group B with group A. We examined the theoretical influence of imbalanced contact matrices on the estimated basic reproduction number (R0). We then explored how imbalanced matrices may bias model-based epidemic projections using an illustrative simulation model of SARS-CoV-2 with 2 age groups (<15 and ≥15 years). Models with imbalanced matrices underestimated the initial spread of SARS-CoV-2, had later time to peak incidence, and had smaller peak incidence. Imbalanced matrices also influenced cumulative infections observed per age group, as well as the estimated impact of an age-specific vaccination strategy. Stratified transmission models that do not consider contact balancing may generate biased projections of epidemic trajectory and the impact of targeted public health interventions. Therefore, modeling studies should implement and report methods used to balance contact matrices for stratified transmission models.
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Affiliation(s)
| | | | - Sharmistha Mishra
- Correspondence to Dr. Sharmistha Mishra, Department of Medicine, University of Toronto, Li Ka Shing Knowledge Institute, Unity Health Toronto, 209 Victoria Street, Toronto M5B 1T8, Canada (e-mail: )
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Özçelik E, Lerouge A, Cecchini M, Cassini A, Allegranzi B. Estimating the return on investment of selected infection prevention and control interventions in healthcare settings for preparing against novel respiratory viruses: modelling the experience from SARS-CoV-2 among health workers. EClinicalMedicine 2024; 68:102388. [PMID: 38273892 PMCID: PMC10809104 DOI: 10.1016/j.eclinm.2023.102388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 12/05/2023] [Accepted: 12/05/2023] [Indexed: 01/27/2024] Open
Abstract
Background Insufficient infection prevention and control (IPC) practices in healthcare settings increase the SARS-CoV-2 infection risk among health workers. This study aimed to examine the level of preparedness for future outbreaks. Methods We modelled the experience from the COVID-19 pandemic and assessed the return on investment on a global scale of three IPC interventions to prevent SARS-CoV-2 infections among health workers: enhancing hand hygiene; increasing access to personal protective equipment (PPE); and combining PPE, with a scale-up of IPC training and education (PPE+). Our analysis covered seven geographic regions, representing a combination of World Health Organization (WHO) regions and the Organisation for Economic Co-operation and Development (OECD) countries. Across all regions, we focused on the first 180 days of the pandemic in 2020 between January 1st and June 30th. We used an extended version of a susceptible-infectious-recovered compartmental model to measure the level of IPC preparedness. Data were sourced from the WHO COVID-19 Detailed Surveillance Database. Findings In all regions, the PPE + intervention would have averted the highest number of new SARS-CoV-2 infections compared to the other two interventions, ranging from 6562 (95% CI 4873-8779) to 38,170 (95% CI 33,853-41,901) new infections per 100,000 health workers in OECD countries and in the South-East Asia region, respectively. Countries in the South-East Asia region and non-OECD countries in the Western Pacific region were poised to achieve the highest level of savings by scaling up the PPE + intervention. Interpretation Our results not only support efforts to make an economic case for continuing investments in IPC interventions to halt the COVID-19 pandemic and protect health workers, but could also contribute to efforts to improve preparedness for future outbreaks. Funding This work was funded by WHO, with support by the German Federal Ministry of Health for the WHOResearch and Development Blueprint for COVID-19.
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Affiliation(s)
- Ece Özçelik
- Organisation for Economic Co-operation and Development, 2 Rue André-Pascale, 75016, Paris, France
| | - Aliénor Lerouge
- Organisation for Economic Co-operation and Development, 2 Rue André-Pascale, 75016, Paris, France
| | - Michele Cecchini
- Organisation for Economic Co-operation and Development, 2 Rue André-Pascale, 75016, Paris, France
| | - Alessandro Cassini
- Infection Prevention and Control Unit, Infectious Diseases Service, Lausanne University Hospital, Lausanne, Switzerland
| | - Benedetta Allegranzi
- Health Emergencies Programme, World Health Organization, Avenue Appia, 1211 Geneva 27, Switzerland
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Chan LYH, Rø G, Midtbø JE, Di Ruscio F, Watle SSV, Juvet LK, Littmann J, Aavitsland P, Nygård KM, Berg AS, Bukholm G, Kristoffersen AB, Engø-Monsen K, Engebretsen S, Swanson D, Palomares ADL, Lindstrøm JC, Frigessi A, de Blasio BF. Modeling geographic vaccination strategies for COVID-19 in Norway. PLoS Comput Biol 2024; 20:e1011426. [PMID: 38295111 PMCID: PMC10861074 DOI: 10.1371/journal.pcbi.1011426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 02/12/2024] [Accepted: 01/08/2024] [Indexed: 02/02/2024] Open
Abstract
Vaccination was a key intervention in controlling the COVID-19 pandemic globally. In early 2021, Norway faced significant regional variations in COVID-19 incidence and prevalence, with large differences in population density, necessitating efficient vaccine allocation to reduce infections and severe outcomes. This study explored alternative vaccination strategies to minimize health outcomes (infections, hospitalizations, ICU admissions, deaths) by varying regions prioritized, extra doses prioritized, and implementation start time. Using two models (individual-based and meta-population), we simulated COVID-19 transmission during the primary vaccination period in Norway, covering the first 7 months of 2021. We investigated alternative strategies to allocate more vaccine doses to regions with a higher force of infection. We also examined the robustness of our results and highlighted potential structural differences between the two models. Our findings suggest that early vaccine prioritization could reduce COVID-19 related health outcomes by 8% to 20% compared to a baseline strategy without geographic prioritization. For minimizing infections, hospitalizations, or ICU admissions, the best strategy was to initially allocate all available vaccine doses to fewer high-risk municipalities, comprising approximately one-fourth of the population. For minimizing deaths, a moderate level of geographic prioritization, with approximately one-third of the population receiving doubled doses, gave the best outcomes by balancing the trade-off between vaccinating younger people in high-risk areas and older people in low-risk areas. The actual strategy implemented in Norway was a two-step moderate level aimed at maintaining the balance and ensuring ethical considerations and public trust. However, it did not offer significant advantages over the baseline strategy without geographic prioritization. Earlier implementation of geographic prioritization could have more effectively addressed the main wave of infections, substantially reducing the national burden of the pandemic.
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Affiliation(s)
- Louis Yat Hin Chan
- Department of Method Development and Analytics, Norwegian Institute of Public Health, Oslo, Norway
| | - Gunnar Rø
- Department of Method Development and Analytics, Norwegian Institute of Public Health, Oslo, Norway
| | - Jørgen Eriksson Midtbø
- Department of Method Development and Analytics, Norwegian Institute of Public Health, Oslo, Norway
| | - Francesco Di Ruscio
- Department of Method Development and Analytics, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Lene Kristine Juvet
- Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
| | - Jasper Littmann
- Division of Infection Control, Norwegian Institute of Public Health, Oslo, Norway
- Bergen Centre for Ethics and Priority Setting (BCEPS), University of Bergen, Bergen, Norway
| | - Preben Aavitsland
- Division of Infection Control, Norwegian Institute of Public Health, Oslo, Norway
- Pandemic Centre, University of Bergen, Bergen, Norway
| | - Karin Maria Nygård
- Department of Infectious Diseases and Preparedness, Norwegian Institute of Public Health, Oslo, Norway
| | - Are Stuwitz Berg
- Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
| | - Geir Bukholm
- Division of Infection Control, Norwegian Institute of Public Health, Oslo, Norway
- Faculty of Chemistry, Biotechnology and Food Sciences, Norwegian University of Life Sciences, Ås, Norway
| | | | | | | | - David Swanson
- Department of Biostatistics, MD Anderson Cancer Center, University of Texas, Houston, Texas, United States of America
| | | | | | - Arnoldo Frigessi
- Oslo Centre for Biostatistics and Epidemiology, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Birgitte Freiesleben de Blasio
- Department of Method Development and Analytics, Norwegian Institute of Public Health, Oslo, Norway
- Oslo Centre for Biostatistics and Epidemiology, University of Oslo and Oslo University Hospital, Oslo, Norway
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Savinkina A, Jurecka C, Gonsalves G, Barocas JA. Mortality, incarceration and cost implications of fentanyl felonization laws: A modeling study. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 121:104175. [PMID: 37729682 PMCID: PMC10840895 DOI: 10.1016/j.drugpo.2023.104175] [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: 03/27/2023] [Revised: 08/16/2023] [Accepted: 08/22/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND Opioid overdose continues to be a major cause of death in the United States. One effort to control opioid use has been to implement policies that enhance criminalization of opioid possession. Laws to further criminalize possession of fentanyl have been enacted or are under consideration across the country, including at the national level. OBJECTIVE Estimate the long-term effects on opioid death and incarceration resulting from increasingly strict fentanyl possession laws . DESIGN We built a Markov simulation model to explore the potential outcomes of a 2022 Colorado law which made possession of >1 g of drug with any amount of fentanyl a Level 4 drug felony (and escalation of the previous law, where >4 g of any drug with any amount of fentanyl in possession was considered a felony). The model simulates a cohort of people with fentanyl possession moving through the criminal justice system, exploring the probability of overdose and incarceration under different scenarios, including various fentanyl possession policies and potential interventions. SETTING Colorado PARTICIPANTS: A simulated cohort of people in possession of fentanyl. MEASUREMENTS Number of opioid overdose deaths, people incarcerated, and associated costs over 5 years. RESULTS When >4 g of a drug containing any amount of fentanyl is considered a felony in Colorado, the model predicts 5460 overdose deaths (95% CrI 410-9260) and 2,740 incarcerations for fentanyl possession (95% CrI: 230-10,500) over 5 years. When the policy changes so that >1 g possession of drug with fentanyl is considered a felony, opioid overdose deaths increase by 19% (95% CRI: 16-38%) and incarcerations for possession increase by 98% (CrI: 85-98%). Diversion programs and MOUD in prison help alleviate some of the increases in death and incarceration, but do not completely offset them. LIMITATIONS The mathematical model is meant to offer broad assessment of the impact of these policies, not forecast specific and exact numerical outcomes. CONCLUSIONS Our model shows that lowering thresholds for felony possession of fentanyl containing drugs can lead to more opioid overdose deaths and incarceration.
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Affiliation(s)
- Alexandra Savinkina
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, United States; Public Health Modeling Unit, Yale School of Public Health, New Haven, CT, United States.
| | - Cole Jurecka
- Divisions of General Internal Medicine and Infectious Diseases, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Gregg Gonsalves
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, United States; Public Health Modeling Unit, Yale School of Public Health, New Haven, CT, United States
| | - Joshua A Barocas
- Divisions of General Internal Medicine and Infectious Diseases, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.
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Pasquale DK, Welsh W, Olson A, Yacoub M, Moody J, Barajas Gomez BA, Bentley-Edwards KL, McCall J, Solis-Guzman ML, Dunn JP, Woods CW, Petzold EA, Bowie AC, Singh K, Huang ES. Scalable Strategies to Increase Efficiency and Augment Public Health Activities During Epidemic Peaks. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2023; 29:863-873. [PMID: 37379511 PMCID: PMC10549909 DOI: 10.1097/phh.0000000000001780] [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] [Indexed: 06/30/2023]
Abstract
OBJECTIVE Scalable strategies to reduce the time burden and increase contact tracing efficiency are crucial during early waves and peaks of infectious transmission. DESIGN We enrolled a cohort of SARS-CoV-2-positive seed cases into a peer recruitment study testing social network methodology and a novel electronic platform to increase contact tracing efficiency. SETTING Index cases were recruited from an academic medical center and requested to recruit their local social contacts for enrollment and SARS-CoV-2 testing. PARTICIPANTS A total of 509 adult participants enrolled over 19 months (384 seed cases and 125 social peers). INTERVENTION Participants completed a survey and were then eligible to recruit their social contacts with unique "coupons" for enrollment. Peer participants were eligible for SARS-CoV-2 and respiratory pathogen screening. MAIN OUTCOME MEASURES The main outcome measures were the percentage of tests administered through the study that identified new SARS-CoV-2 cases, the feasibility of deploying the platform and the peer recruitment strategy, the perceived acceptability of the platform and the peer recruitment strategy, and the scalability of both during pandemic peaks. RESULTS After development and deployment, few human resources were needed to maintain the platform and enroll participants, regardless of peaks. Platform acceptability was high. Percent positivity tracked with other testing programs in the area. CONCLUSIONS An electronic platform may be a suitable tool to augment public health contact tracing activities by allowing participants to select an online platform for contact tracing rather than sitting for an interview.
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Affiliation(s)
- Dana K. Pasquale
- Department of Population Health Sciences (Dr Pasquale), Department of Sociology (Drs Pasquale and Moody), Social Science Research Institute (Dr Welsh), Duke AI Health, School of Medicine (Messrs Olson and McCall), Duke Population Research Institute (Mr Yacoub), Duke Network Analysis Center (Dr Moody), Duke Office of Clinical Research, School of Medicine (Ms Barajas Gomez), Samuel DuBois Cook Center on Social Equity (Dr Bentley-Edwards), Department of Biomedical Engineering, Pratt School of Engineering (Dr Dunn and Ms Singh), Department of Biostatistics & Bioinformatics (Drs Dunn and Huang), Department of Medicine, School of Medicine (Dr Woods), Duke Global Health Institute (Dr Woods), Center for Infectious Disease Diagnostics & Innovation (Drs Petzold and Bowie), and Department of Surgery (Dr Huang), Duke University, Durham, North Carolina; LUMA Consulting, Durham, North Carolina (Ms Solis-Guzman); and Verily Life Sciences, South San Francisco, California (Dr Huang)
| | - Whitney Welsh
- Department of Population Health Sciences (Dr Pasquale), Department of Sociology (Drs Pasquale and Moody), Social Science Research Institute (Dr Welsh), Duke AI Health, School of Medicine (Messrs Olson and McCall), Duke Population Research Institute (Mr Yacoub), Duke Network Analysis Center (Dr Moody), Duke Office of Clinical Research, School of Medicine (Ms Barajas Gomez), Samuel DuBois Cook Center on Social Equity (Dr Bentley-Edwards), Department of Biomedical Engineering, Pratt School of Engineering (Dr Dunn and Ms Singh), Department of Biostatistics & Bioinformatics (Drs Dunn and Huang), Department of Medicine, School of Medicine (Dr Woods), Duke Global Health Institute (Dr Woods), Center for Infectious Disease Diagnostics & Innovation (Drs Petzold and Bowie), and Department of Surgery (Dr Huang), Duke University, Durham, North Carolina; LUMA Consulting, Durham, North Carolina (Ms Solis-Guzman); and Verily Life Sciences, South San Francisco, California (Dr Huang)
| | - Andrew Olson
- Department of Population Health Sciences (Dr Pasquale), Department of Sociology (Drs Pasquale and Moody), Social Science Research Institute (Dr Welsh), Duke AI Health, School of Medicine (Messrs Olson and McCall), Duke Population Research Institute (Mr Yacoub), Duke Network Analysis Center (Dr Moody), Duke Office of Clinical Research, School of Medicine (Ms Barajas Gomez), Samuel DuBois Cook Center on Social Equity (Dr Bentley-Edwards), Department of Biomedical Engineering, Pratt School of Engineering (Dr Dunn and Ms Singh), Department of Biostatistics & Bioinformatics (Drs Dunn and Huang), Department of Medicine, School of Medicine (Dr Woods), Duke Global Health Institute (Dr Woods), Center for Infectious Disease Diagnostics & Innovation (Drs Petzold and Bowie), and Department of Surgery (Dr Huang), Duke University, Durham, North Carolina; LUMA Consulting, Durham, North Carolina (Ms Solis-Guzman); and Verily Life Sciences, South San Francisco, California (Dr Huang)
| | - Mark Yacoub
- Department of Population Health Sciences (Dr Pasquale), Department of Sociology (Drs Pasquale and Moody), Social Science Research Institute (Dr Welsh), Duke AI Health, School of Medicine (Messrs Olson and McCall), Duke Population Research Institute (Mr Yacoub), Duke Network Analysis Center (Dr Moody), Duke Office of Clinical Research, School of Medicine (Ms Barajas Gomez), Samuel DuBois Cook Center on Social Equity (Dr Bentley-Edwards), Department of Biomedical Engineering, Pratt School of Engineering (Dr Dunn and Ms Singh), Department of Biostatistics & Bioinformatics (Drs Dunn and Huang), Department of Medicine, School of Medicine (Dr Woods), Duke Global Health Institute (Dr Woods), Center for Infectious Disease Diagnostics & Innovation (Drs Petzold and Bowie), and Department of Surgery (Dr Huang), Duke University, Durham, North Carolina; LUMA Consulting, Durham, North Carolina (Ms Solis-Guzman); and Verily Life Sciences, South San Francisco, California (Dr Huang)
| | - James Moody
- Department of Population Health Sciences (Dr Pasquale), Department of Sociology (Drs Pasquale and Moody), Social Science Research Institute (Dr Welsh), Duke AI Health, School of Medicine (Messrs Olson and McCall), Duke Population Research Institute (Mr Yacoub), Duke Network Analysis Center (Dr Moody), Duke Office of Clinical Research, School of Medicine (Ms Barajas Gomez), Samuel DuBois Cook Center on Social Equity (Dr Bentley-Edwards), Department of Biomedical Engineering, Pratt School of Engineering (Dr Dunn and Ms Singh), Department of Biostatistics & Bioinformatics (Drs Dunn and Huang), Department of Medicine, School of Medicine (Dr Woods), Duke Global Health Institute (Dr Woods), Center for Infectious Disease Diagnostics & Innovation (Drs Petzold and Bowie), and Department of Surgery (Dr Huang), Duke University, Durham, North Carolina; LUMA Consulting, Durham, North Carolina (Ms Solis-Guzman); and Verily Life Sciences, South San Francisco, California (Dr Huang)
| | - Brisa A. Barajas Gomez
- Department of Population Health Sciences (Dr Pasquale), Department of Sociology (Drs Pasquale and Moody), Social Science Research Institute (Dr Welsh), Duke AI Health, School of Medicine (Messrs Olson and McCall), Duke Population Research Institute (Mr Yacoub), Duke Network Analysis Center (Dr Moody), Duke Office of Clinical Research, School of Medicine (Ms Barajas Gomez), Samuel DuBois Cook Center on Social Equity (Dr Bentley-Edwards), Department of Biomedical Engineering, Pratt School of Engineering (Dr Dunn and Ms Singh), Department of Biostatistics & Bioinformatics (Drs Dunn and Huang), Department of Medicine, School of Medicine (Dr Woods), Duke Global Health Institute (Dr Woods), Center for Infectious Disease Diagnostics & Innovation (Drs Petzold and Bowie), and Department of Surgery (Dr Huang), Duke University, Durham, North Carolina; LUMA Consulting, Durham, North Carolina (Ms Solis-Guzman); and Verily Life Sciences, South San Francisco, California (Dr Huang)
| | - Keisha L. Bentley-Edwards
- Department of Population Health Sciences (Dr Pasquale), Department of Sociology (Drs Pasquale and Moody), Social Science Research Institute (Dr Welsh), Duke AI Health, School of Medicine (Messrs Olson and McCall), Duke Population Research Institute (Mr Yacoub), Duke Network Analysis Center (Dr Moody), Duke Office of Clinical Research, School of Medicine (Ms Barajas Gomez), Samuel DuBois Cook Center on Social Equity (Dr Bentley-Edwards), Department of Biomedical Engineering, Pratt School of Engineering (Dr Dunn and Ms Singh), Department of Biostatistics & Bioinformatics (Drs Dunn and Huang), Department of Medicine, School of Medicine (Dr Woods), Duke Global Health Institute (Dr Woods), Center for Infectious Disease Diagnostics & Innovation (Drs Petzold and Bowie), and Department of Surgery (Dr Huang), Duke University, Durham, North Carolina; LUMA Consulting, Durham, North Carolina (Ms Solis-Guzman); and Verily Life Sciences, South San Francisco, California (Dr Huang)
| | - Jonathan McCall
- Department of Population Health Sciences (Dr Pasquale), Department of Sociology (Drs Pasquale and Moody), Social Science Research Institute (Dr Welsh), Duke AI Health, School of Medicine (Messrs Olson and McCall), Duke Population Research Institute (Mr Yacoub), Duke Network Analysis Center (Dr Moody), Duke Office of Clinical Research, School of Medicine (Ms Barajas Gomez), Samuel DuBois Cook Center on Social Equity (Dr Bentley-Edwards), Department of Biomedical Engineering, Pratt School of Engineering (Dr Dunn and Ms Singh), Department of Biostatistics & Bioinformatics (Drs Dunn and Huang), Department of Medicine, School of Medicine (Dr Woods), Duke Global Health Institute (Dr Woods), Center for Infectious Disease Diagnostics & Innovation (Drs Petzold and Bowie), and Department of Surgery (Dr Huang), Duke University, Durham, North Carolina; LUMA Consulting, Durham, North Carolina (Ms Solis-Guzman); and Verily Life Sciences, South San Francisco, California (Dr Huang)
| | - Maria Luisa Solis-Guzman
- Department of Population Health Sciences (Dr Pasquale), Department of Sociology (Drs Pasquale and Moody), Social Science Research Institute (Dr Welsh), Duke AI Health, School of Medicine (Messrs Olson and McCall), Duke Population Research Institute (Mr Yacoub), Duke Network Analysis Center (Dr Moody), Duke Office of Clinical Research, School of Medicine (Ms Barajas Gomez), Samuel DuBois Cook Center on Social Equity (Dr Bentley-Edwards), Department of Biomedical Engineering, Pratt School of Engineering (Dr Dunn and Ms Singh), Department of Biostatistics & Bioinformatics (Drs Dunn and Huang), Department of Medicine, School of Medicine (Dr Woods), Duke Global Health Institute (Dr Woods), Center for Infectious Disease Diagnostics & Innovation (Drs Petzold and Bowie), and Department of Surgery (Dr Huang), Duke University, Durham, North Carolina; LUMA Consulting, Durham, North Carolina (Ms Solis-Guzman); and Verily Life Sciences, South San Francisco, California (Dr Huang)
| | - Jessilyn P. Dunn
- Department of Population Health Sciences (Dr Pasquale), Department of Sociology (Drs Pasquale and Moody), Social Science Research Institute (Dr Welsh), Duke AI Health, School of Medicine (Messrs Olson and McCall), Duke Population Research Institute (Mr Yacoub), Duke Network Analysis Center (Dr Moody), Duke Office of Clinical Research, School of Medicine (Ms Barajas Gomez), Samuel DuBois Cook Center on Social Equity (Dr Bentley-Edwards), Department of Biomedical Engineering, Pratt School of Engineering (Dr Dunn and Ms Singh), Department of Biostatistics & Bioinformatics (Drs Dunn and Huang), Department of Medicine, School of Medicine (Dr Woods), Duke Global Health Institute (Dr Woods), Center for Infectious Disease Diagnostics & Innovation (Drs Petzold and Bowie), and Department of Surgery (Dr Huang), Duke University, Durham, North Carolina; LUMA Consulting, Durham, North Carolina (Ms Solis-Guzman); and Verily Life Sciences, South San Francisco, California (Dr Huang)
| | - Christopher W. Woods
- Department of Population Health Sciences (Dr Pasquale), Department of Sociology (Drs Pasquale and Moody), Social Science Research Institute (Dr Welsh), Duke AI Health, School of Medicine (Messrs Olson and McCall), Duke Population Research Institute (Mr Yacoub), Duke Network Analysis Center (Dr Moody), Duke Office of Clinical Research, School of Medicine (Ms Barajas Gomez), Samuel DuBois Cook Center on Social Equity (Dr Bentley-Edwards), Department of Biomedical Engineering, Pratt School of Engineering (Dr Dunn and Ms Singh), Department of Biostatistics & Bioinformatics (Drs Dunn and Huang), Department of Medicine, School of Medicine (Dr Woods), Duke Global Health Institute (Dr Woods), Center for Infectious Disease Diagnostics & Innovation (Drs Petzold and Bowie), and Department of Surgery (Dr Huang), Duke University, Durham, North Carolina; LUMA Consulting, Durham, North Carolina (Ms Solis-Guzman); and Verily Life Sciences, South San Francisco, California (Dr Huang)
| | - Elizabeth A. Petzold
- Department of Population Health Sciences (Dr Pasquale), Department of Sociology (Drs Pasquale and Moody), Social Science Research Institute (Dr Welsh), Duke AI Health, School of Medicine (Messrs Olson and McCall), Duke Population Research Institute (Mr Yacoub), Duke Network Analysis Center (Dr Moody), Duke Office of Clinical Research, School of Medicine (Ms Barajas Gomez), Samuel DuBois Cook Center on Social Equity (Dr Bentley-Edwards), Department of Biomedical Engineering, Pratt School of Engineering (Dr Dunn and Ms Singh), Department of Biostatistics & Bioinformatics (Drs Dunn and Huang), Department of Medicine, School of Medicine (Dr Woods), Duke Global Health Institute (Dr Woods), Center for Infectious Disease Diagnostics & Innovation (Drs Petzold and Bowie), and Department of Surgery (Dr Huang), Duke University, Durham, North Carolina; LUMA Consulting, Durham, North Carolina (Ms Solis-Guzman); and Verily Life Sciences, South San Francisco, California (Dr Huang)
| | - Aleah C. Bowie
- Department of Population Health Sciences (Dr Pasquale), Department of Sociology (Drs Pasquale and Moody), Social Science Research Institute (Dr Welsh), Duke AI Health, School of Medicine (Messrs Olson and McCall), Duke Population Research Institute (Mr Yacoub), Duke Network Analysis Center (Dr Moody), Duke Office of Clinical Research, School of Medicine (Ms Barajas Gomez), Samuel DuBois Cook Center on Social Equity (Dr Bentley-Edwards), Department of Biomedical Engineering, Pratt School of Engineering (Dr Dunn and Ms Singh), Department of Biostatistics & Bioinformatics (Drs Dunn and Huang), Department of Medicine, School of Medicine (Dr Woods), Duke Global Health Institute (Dr Woods), Center for Infectious Disease Diagnostics & Innovation (Drs Petzold and Bowie), and Department of Surgery (Dr Huang), Duke University, Durham, North Carolina; LUMA Consulting, Durham, North Carolina (Ms Solis-Guzman); and Verily Life Sciences, South San Francisco, California (Dr Huang)
| | - Karnika Singh
- Department of Population Health Sciences (Dr Pasquale), Department of Sociology (Drs Pasquale and Moody), Social Science Research Institute (Dr Welsh), Duke AI Health, School of Medicine (Messrs Olson and McCall), Duke Population Research Institute (Mr Yacoub), Duke Network Analysis Center (Dr Moody), Duke Office of Clinical Research, School of Medicine (Ms Barajas Gomez), Samuel DuBois Cook Center on Social Equity (Dr Bentley-Edwards), Department of Biomedical Engineering, Pratt School of Engineering (Dr Dunn and Ms Singh), Department of Biostatistics & Bioinformatics (Drs Dunn and Huang), Department of Medicine, School of Medicine (Dr Woods), Duke Global Health Institute (Dr Woods), Center for Infectious Disease Diagnostics & Innovation (Drs Petzold and Bowie), and Department of Surgery (Dr Huang), Duke University, Durham, North Carolina; LUMA Consulting, Durham, North Carolina (Ms Solis-Guzman); and Verily Life Sciences, South San Francisco, California (Dr Huang)
| | - Erich S. Huang
- Department of Population Health Sciences (Dr Pasquale), Department of Sociology (Drs Pasquale and Moody), Social Science Research Institute (Dr Welsh), Duke AI Health, School of Medicine (Messrs Olson and McCall), Duke Population Research Institute (Mr Yacoub), Duke Network Analysis Center (Dr Moody), Duke Office of Clinical Research, School of Medicine (Ms Barajas Gomez), Samuel DuBois Cook Center on Social Equity (Dr Bentley-Edwards), Department of Biomedical Engineering, Pratt School of Engineering (Dr Dunn and Ms Singh), Department of Biostatistics & Bioinformatics (Drs Dunn and Huang), Department of Medicine, School of Medicine (Dr Woods), Duke Global Health Institute (Dr Woods), Center for Infectious Disease Diagnostics & Innovation (Drs Petzold and Bowie), and Department of Surgery (Dr Huang), Duke University, Durham, North Carolina; LUMA Consulting, Durham, North Carolina (Ms Solis-Guzman); and Verily Life Sciences, South San Francisco, California (Dr Huang)
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12
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Elgart S. A perturbative approach to the analysis of many-compartment models characterized by the presence of waning immunity. J Math Biol 2023; 87:61. [PMID: 37735281 DOI: 10.1007/s00285-023-01994-6] [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: 06/19/2022] [Revised: 08/23/2023] [Accepted: 08/31/2023] [Indexed: 09/23/2023]
Abstract
The waning of immunity after recovery or vaccination is a major factor accounting for the severity and prolonged duration of an array of epidemics, ranging from COVID-19 to diphtheria and pertussis. To study the effectiveness of different immunity level-based vaccination schemes in mitigating the impact of waning immunity, we construct epidemiological models that mimic the latter's effect. The total susceptible population is divided into an arbitrarily large number of discrete compartments with varying levels of disease immunity. We then vaccinate various compartments within this framework, comparing the value of [Formula: see text] and the equilibria locations for our systems to determine an optimal immunization scheme under natural constraints. Relying on perturbative analysis, we establish a number of results concerning the location, existence, and uniqueness of the system's endemic equilibria, as well as results on disease-free equilibria. We use numerical techniques to supplement our analytical ones, applying our model to waning immunity dynamics in pertussis, among other diseases. Our analytical results are applicable to a wide range of systems composed of arbitrarily many ODEs.
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13
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Ko Y, Peck KR, Kim YJ, Kim DH, Jung E. Effective vaccination strategies to control COVID-19 in Korea: a modeling study. Epidemiol Health 2023; 45:e2023084. [PMID: 37723841 PMCID: PMC10867522 DOI: 10.4178/epih.e2023084] [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: 06/19/2023] [Accepted: 08/07/2023] [Indexed: 09/20/2023] Open
Abstract
OBJECTIVES In Korea, as immunity levels of the coronavirus disease 2019 (COVID-19) in the population acquired through previous infections and vaccinations have decreased, booster vaccinations have emerged as a necessary measure to control new outbreaks. The objective of this study was to identify the most suitable vaccination strategy for controlling the surge in COVID-19 cases. METHODS A mathematical model was developed to concurrently evaluate the immunity levels induced by vaccines and infections. This model was then employed to investigate the potential for future resurgence and the possibility of control through the use of vaccines and antivirals. RESULTS As of May 11, 2023, if the current epidemic trend persists without further vaccination efforts, a peak in resurgence is anticipated to occur around mid-October of the same year. Under the most favorable circumstances, the peak number of severely hospitalized patients could be reduced by 43% (n=480) compared to the scenario without vaccine intervention (n=849). Depending on outbreak trends and vaccination strategies, the best timing for vaccination in terms of minimizing this peak varies from May 2023 to August 2023. CONCLUSIONS Our findings suggest that if the epidemic persist, the best timing for administering vaccinations would need to be earlier than currently outlined in the Korean plan. It is imperative to continue monitoring outbreak trends, as this is key to determining the best vaccination timing in order to manage potential future surges.
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Affiliation(s)
- Youngsuk Ko
- Department of Mathematics, Konkuk University, Seoul, Korea
| | - Kyong Ran Peck
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yae-Jean Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong-Hyun Kim
- Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Eunok Jung
- Department of Mathematics, Konkuk University, Seoul, Korea
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14
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Panaggio MJ, Wilson SN, Ratcliff JD, Mullany LC, Freeman JD, Rainwater-Lovett K. On the Mark: Modeling and Forecasting for Public Health Impact. Health Secur 2023; 21:S79-S88. [PMID: 37756211 DOI: 10.1089/hs.2023.0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023] Open
Affiliation(s)
- Mark J Panaggio
- Mark J. Panaggio, PhD, is Applied Mathematicians/Data Scientists, Johns Hopkins University Applied Physics
| | - Shelby N Wilson
- Shelby N. Wilson, PhD, is Applied Mathematicians/Data Scientists, Johns Hopkins University Applied Physics
| | - Jeremy D Ratcliff
- Jeremy D. Ratcliff, PhD, is a Senior Scientist, Asymmetric Operations Sector, Johns Hopkins University Applied Physics
| | - Luke C Mullany
- Luke C. Mullany, PhD, MS, MHS, is a Senior Researcher, Research and Exploratory Development Department, Johns Hopkins University Applied Physics
| | - Jeffrey D Freeman
- Jeffrey D. Freeman, PhD, MPH, is Director and Special Assistant to the President, National Center for Disaster Medicine and Public Health, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Kaitlin Rainwater-Lovett
- Kaitlin Rainwater-Lovett, PhD, MPH, is Assistant Program Manager, Johns Hopkins University Applied Physics Laboratory, Laurel, MD
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15
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Tedeschi LO. Review: Harnessing extant energy and protein requirement modeling for sustainable beef production. Animal 2023; 17 Suppl 3:100835. [PMID: 37210232 DOI: 10.1016/j.animal.2023.100835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 05/22/2023] Open
Abstract
Numerous mathematical nutrition models have been developed in the last sixty years to predict the dietary supply and requirement of farm animals' energy and protein. Although these models, usually developed by different groups, share similar concepts and data, their calculation routines (i.e., submodels) have rarely been combined into generalized models. This lack of mixing submodels is partly because different models have different attributes, including paradigms, structural decisions, inputs/outputs, and parameterization processes that could render them incompatible for merging. Another reason is that predictability might increase due to offsetting errors that cannot be thoroughly studied. Alternatively, combining concepts might be more accessible and safer than combining models' calculation routines because concepts can be incorporated into existing models without changing the modeling structure and calculation logic, though additional inputs might be needed. Instead of developing new models, improving the merging of extant models' concepts might curtail the time and effort needed to develop models capable of evaluating aspects of sustainability. Two areas of beef production research that are needed to ensure adequate diet formulation include accurate energy requirements of grazing animals (decrease methane emissions) and efficiency of energy use (reduce carcass waste and resource use) by growing cattle. A revised model for energy expenditure of grazing animals was proposed to incorporate the energy needed for physical activity, as the British feeding system recommended, and eating and rumination (HjEer) into the total energy requirement. Unfortunately, the proposed equation can only be solved iteratively through optimization because HjEer requires metabolizable energy (ME) intake. The other revised model expanded an existing model to estimate the partial efficiency of using ME for growth (kg) from protein proportion in the retained energy by including an animal degree of maturity and average daily gain (ADG) as used in the Australian feeding system. The revised kg model uses carcass composition, and it is less dependent on dietary ME content, but still requires an accurate assessment of the degree of maturity and ADG, which in turn depends on the kg. Therefore, it needs to be solved iteratively or using one-step delayed continuous calculation (i.e., use the previous day's ADG to compute the current day's kg). We believe that generalized models developed by merging different models' concepts might improve our understanding of the relationships of existing variables that were known for their importance but not included in extant models because of the lack of proper information or confidence at that time.
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Affiliation(s)
- L O Tedeschi
- Department of Animal Science, Texas A&M University, College Station, TX 77843-2471, United States.
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16
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Scott N, Abeysuriya RG, Delport D, Sacks-Davis R, Nolan J, West D, Sutton B, Wallace EM, Hellard M. COVID-19 epidemic modelling for policy decision support in Victoria, Australia 2020-2021. BMC Public Health 2023; 23:988. [PMID: 37237343 DOI: 10.1186/s12889-023-15936-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 05/19/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Policy responses to COVID-19 in Victoria, Australia over 2020-2021 have been supported by evidence generated through mathematical modelling. This study describes the design, key findings, and process for policy translation of a series of modelling studies conducted for the Victorian Department of Health COVID-19 response team during this period. METHODS An agent-based model, Covasim, was used to simulate the impact of policy interventions on COVID-19 outbreaks and epidemic waves. The model was continually adapted to enable scenario analysis of settings or policies being considered at the time (e.g. elimination of community transmission versus disease control). Model scenarios were co-designed with government, to fill evidence gaps prior to key decisions. RESULTS Understanding outbreak risk following incursions was critical to eliminating community COVID-19 transmission. Analyses showed risk depended on whether the first detected case was the index case, a primary contact of the index case, or a 'mystery case'. There were benefits of early lockdown on first case detection and gradual easing of restrictions to minimise resurgence risk from undetected cases. As vaccination coverage increased and the focus shifted to controlling rather than eliminating community transmission, understanding health system demand was critical. Analyses showed that vaccines alone could not protect health systems and need to be complemented with other public health measures. CONCLUSIONS Model evidence offered the greatest value when decisions needed to be made pre-emptively, or for questions that could not be answered with empiric data and data analysis alone. Co-designing scenarios with policy-makers ensured relevance and increased policy translation.
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Affiliation(s)
- Nick Scott
- Disease Elimination Program, Burnet Institute, 85 Commercial Rd, Melbourne, Victoria, Australia.
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Romesh G Abeysuriya
- Disease Elimination Program, Burnet Institute, 85 Commercial Rd, Melbourne, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Dominic Delport
- Disease Elimination Program, Burnet Institute, 85 Commercial Rd, Melbourne, Victoria, Australia
| | - Rachel Sacks-Davis
- Disease Elimination Program, Burnet Institute, 85 Commercial Rd, Melbourne, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jonathan Nolan
- Victorian Government Department of Health, Victoria, Australia
| | - Daniel West
- Victorian Government Department of Health, Victoria, Australia
| | - Brett Sutton
- Victorian Government Department of Health, Victoria, Australia
| | - Euan M Wallace
- Victorian Government Department of Health, Victoria, Australia
| | - Margaret Hellard
- Disease Elimination Program, Burnet Institute, 85 Commercial Rd, Melbourne, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
- Department of Infectious Diseases, The Alfred and Monash University, Melbourne, Victoria, Australia
- Department of Infectious Diseases, Doherty Institute, The University of Melbourne, Parkville, Victoria, Australia
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Banuet-Martinez M, Yang Y, Jafari B, Kaur A, Butt ZA, Chen HH, Yanushkevich S, Moyles IR, Heffernan JM, Korosec CS. Monkeypox: a review of epidemiological modelling studies and how modelling has led to mechanistic insight. Epidemiol Infect 2023; 151:e121. [PMID: 37218612 PMCID: PMC10468816 DOI: 10.1017/s0950268823000791] [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: 02/13/2023] [Revised: 05/04/2023] [Accepted: 05/11/2023] [Indexed: 05/24/2023] Open
Abstract
Human monkeypox (mpox) virus is a viral zoonosis that belongs to the Orthopoxvirus genus of the Poxviridae family, which presents with similar symptoms as those seen in human smallpox patients. Mpox is an increasing concern globally, with over 80,000 cases in non-endemic countries as of December 2022. In this review, we provide a brief history and ecology of mpox, its basic virology, and the key differences in mpox viral fitness traits before and after 2022. We summarize and critique current knowledge from epidemiological mathematical models, within-host models, and between-host transmission models using the One Health approach, where we distinguish between models that focus on immunity from vaccination, geography, climatic variables, as well as animal models. We report various epidemiological parameters, such as the reproduction number, R0, in a condensed format to facilitate comparison between studies. We focus on how mathematical modelling studies have led to novel mechanistic insight into mpox transmission and pathogenesis. As mpox is predicted to lead to further infection peaks in many historically non-endemic countries, mathematical modelling studies of mpox can provide rapid actionable insights into viral dynamics to guide public health measures and mitigation strategies.
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Affiliation(s)
- Marina Banuet-Martinez
- Climate Change and Global Health Research Group, School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Yang Yang
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Behnaz Jafari
- Mathematics and Statistics Department, Faculty of Science, University of Calgary, Calgary, AB, Canada
- Department of Biomedical Engineering, Schulich School of Engineering, University of Calgary, Calgary, AB, Canada
| | - Avneet Kaur
- Irving K. Barber School of Arts and Sciences, Department of Computer Science, Mathematics, Physics and Statistics, University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Zahid A. Butt
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Helen H. Chen
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Svetlana Yanushkevich
- Department of Biomedical Engineering, Schulich School of Engineering, University of Calgary, Calgary, AB, Canada
| | - Iain R. Moyles
- Modelling Infection and Immunity Lab, Mathematics and Statistics, York University, Toronto, ON, Canada
- Centre for Disease Modelling, Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Jane M. Heffernan
- Modelling Infection and Immunity Lab, Mathematics and Statistics, York University, Toronto, ON, Canada
- Centre for Disease Modelling, Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Chapin S. Korosec
- Modelling Infection and Immunity Lab, Mathematics and Statistics, York University, Toronto, ON, Canada
- Centre for Disease Modelling, Mathematics and Statistics, York University, Toronto, ON, Canada
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Abuelezam NN, Michel I, Marshall BD, Galea S. Accounting for historical injustices in mathematical models of infectious disease transmission: An analytic overview. Epidemics 2023; 43:100679. [PMID: 36924757 DOI: 10.1016/j.epidem.2023.100679] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 02/24/2023] [Accepted: 03/06/2023] [Indexed: 03/13/2023] Open
Abstract
Differences in infectious disease risk, acquisition, and severity arise from intersectional systems of oppression and resulting historical injustices that shape individual behavior and circumstance. We define historical injustices as distinct events and policies that arise out of intersectional systems of oppression. We view historical injustices as a medium through which structural forces affect health both directly and indirectly, and are thus important to study in the context of infectious disease disparities. In this critical analysis we aim to highlight the importance of incorporating historical injustices into mathematical models of infectious disease transmission and provide context on the methodologies to do so. We offer two illustrations of elements of model building (i.e., parameterization, validation and calibration) that can allow for a better understanding of health disparities in infectious disease outcomes. Mathematical models that do not recognize the historical forces that underlie infectious disease dynamics inevitably lead to the individualization of our focus and the recommendation of untenable individual-behavioral prescriptions to address the burden of infectious disease.
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Affiliation(s)
- Nadia N Abuelezam
- Boston College, William F. Connell School of Nursing, Chestnut Hill, MA, USA.
| | - Isaacson Michel
- Boston College, William F. Connell School of Nursing, Chestnut Hill, MA, USA.
| | - Brandon Dl Marshall
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA.
| | - Sandro Galea
- Boston University, School of Public Health, Boston, MA, USA.
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19
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Beaunée G, Deslandes F, Vergu E. Inferring ASF transmission in domestic pigs and wild boars using a paired model iterative approach. Epidemics 2023; 42:100665. [PMID: 36689877 DOI: 10.1016/j.epidem.2023.100665] [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: 11/30/2021] [Revised: 12/15/2022] [Accepted: 01/04/2023] [Indexed: 01/15/2023] Open
Abstract
The rapid spread of African swine fever (ASF) in recent years has once again raised awareness of the need to improve our preparedness in preventing and managing outbreaks, for which modelling-based forecasts can play an important role. This is even more important in the case of a disease such as ASF, involving several types of hosts, characterised by a high case-fatality rate and for which there is currently no treatment or vaccine. Within the framework of the ASF challenge, we proposed a modelling approach based on a stochastic mechanistic model and an inference procedure to estimate key transmission parameters from provided data (incomplete and noisy) and generate forecasts for unobserved time horizons. The model is partly data driven and composed of two modules, corresponding to epidemic and demographic dynamics in domestic pig and wild boar (WB) populations, interconnected through the networks of animal trade and/or spatial proximity. The inference consists in an iterative procedure, alternating between the two models and based on a criterion optimisation. Estimates of transmission and detection parameters appeared to be of similar magnitude for each of the three periods of the challenge, except for the transmission rates in WB population through contact with infectious individuals and carcasses, higher during the first period. The predicted number of infected domestic pig farms was in overall agreement with the data. The proportion of positive tested WB was overestimated, but with a trend close to that observed in the data. Comparison of the spatial simulated and observed distributions of detected cases also showed an overestimation of the spread of the pathogen within WB metapopulation. Beyond the quantitative results and the inherent difficulties of real-time forecasting, we built a modelling framework that is flexible enough to accommodate changes in transmission processes and control measures that may occur during an epidemic emergency.
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Affiliation(s)
- G Beaunée
- Oniris, INRAE, BIOEPAR, 44300, Nantes, France.
| | - F Deslandes
- Université Paris-Saclay, INRAE, MaIAGE, 78350, Jouy-en-Josas, France
| | - E Vergu
- Université Paris-Saclay, INRAE, MaIAGE, 78350, Jouy-en-Josas, France
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20
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Frequent and unpredictable changes in COVID-19 policies and restrictions reduce the accuracy of model forecasts. Sci Rep 2023; 13:1398. [PMID: 36697434 PMCID: PMC9875165 DOI: 10.1038/s41598-023-27711-3] [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: 02/01/2022] [Accepted: 01/06/2023] [Indexed: 01/27/2023] Open
Abstract
Between June and August 2020, an agent-based model was used to project rates of COVID-19 infection incidence and cases diagnosed as positive from 15 September to 31 October 2020 for 72 geographic settings. Five scenarios were modelled: a baseline scenario where no future changes were made to existing restrictions, and four scenarios representing small or moderate changes in restrictions at two intervals. Post hoc, upper and lower bounds for number of diagnosed Covid-19 cases were compared with actual data collected during the prediction window. A regression analysis with 17 covariates was performed to determine correlates of accurate projections. It was found that the actual data fell within the lower and upper bounds in 27 settings and out of bounds in 45 settings. The only statistically significant predictor of actual data within the predicted bounds was correct assumptions about future policy changes (OR 15.04; 95% CI 2.20-208.70; p = 0.016). Frequent changes in restrictions implemented by governments, which the modelling team was not always able to predict, in part explains why the majority of model projections were inaccurate compared with actual outcomes and supports revision of projections when policies are changed as well as the importance of modelling teams collaborating with policy experts.
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21
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Zhu A, Bruketa E, Svoboda T, Patel J, Elmi N, El-Khechen Richandi G, Baral S, Orkin AM. Respiratory infectious disease outbreaks among people experiencing homelessness: a systematic review of prevention and mitigation strategies. Ann Epidemiol 2023; 77:127-135. [PMID: 35342013 DOI: 10.1016/j.annepidem.2022.03.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 02/16/2022] [Accepted: 03/05/2022] [Indexed: 01/04/2023]
Abstract
PURPOSE People experiencing homelessness (PEH) are at increased risk of respiratory infections and associated morbidity and mortality. To characterize optimal intervention strategies, we completed a systematic review of mitigation strategies for PEH to minimize the spread and impact of respiratory infectious disease outbreaks, including COVID-19. METHODS The study protocol was registered in PROSPERO (#2020 CRD42020208964) and was consistent with the preferred reporting in systematic reviews and meta-analyses guidelines. A search algorithm containing keywords that were synonymous to the terms "Homeless" and "Respiratory Illness" was applied to the six databases. The search concluded on September 22, 2020. Quality assessment was performed at the study level. Steps were conducted by two independent team members. RESULTS A total of 4468 unique titles were retrieved with 21 meeting criteria for inclusion. Interventions included testing, tracking, screening, infection prevention and control, isolation support, and education. Historically, there has been limited study of intervention strategies specifically for PEH across the world. CONCLUSIONS Staff and organizations providing services for people experiencing homelessness face specific challenges in adhering to public health guidelines such as physical distancing, isolation, and routine hygiene practices. There is a discrepancy between the burden of infectious diseases among PEH and specific research characterizing optimal intervention strategies to mitigate transmission in the context of shelters. Improving health for people experiencing homelessness necessitates investment in programs scaling existing interventions and research to study new approaches.
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Affiliation(s)
- Alice Zhu
- Population Health Service, Inner City Health Associates. Toronto, ON, Canada; Department of Family and Community Medicine, University of Toronto, ON, Canada; Department of General Surgery, University of Toronto, Toronto, ON, Canada
| | - Eva Bruketa
- Population Health Service, Inner City Health Associates. Toronto, ON, Canada; Queen's University, School of Medicine, Kingston, ON, Canada
| | - Tomislav Svoboda
- Population Health Service, Inner City Health Associates. Toronto, ON, Canada; Department of Family and Community Medicine, University of Toronto, ON, Canada
| | - Jamie Patel
- Population Health Service, Inner City Health Associates. Toronto, ON, Canada; Ryerson University, Daphne Cockwell School of Nursing, Toronto, ON, Canada
| | - Nika Elmi
- Population Health Service, Inner City Health Associates. Toronto, ON, Canada; Johns Hopkins School of Public Health, Baltimore, MD, USA
| | | | - Stefan Baral
- Population Health Service, Inner City Health Associates. Toronto, ON, Canada; Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Aaron M Orkin
- Population Health Service, Inner City Health Associates. Toronto, ON, Canada; Department of Family and Community Medicine, University of Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, ON, Canada.
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22
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Human papillomavirus vaccination strategies for accelerating action towards cervical cancer elimination. Lancet Glob Health 2023; 11:e4-e5. [PMID: 36521950 PMCID: PMC9833425 DOI: 10.1016/s2214-109x(22)00511-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 11/18/2022] [Indexed: 12/15/2022]
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23
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Kevrekidis GA, Rapti Z, Drossinos Y, Kevrekidis PG, Barmann MA, Chen QY, Cuevas-Maraver J. Backcasting COVID-19: a physics-informed estimate for early case incidence. ROYAL SOCIETY OPEN SCIENCE 2022; 9:220329. [PMID: 36533196 PMCID: PMC9748501 DOI: 10.1098/rsos.220329] [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: 03/14/2022] [Accepted: 11/17/2022] [Indexed: 06/17/2023]
Abstract
It is widely accepted that the number of reported cases during the first stages of the COVID-19 pandemic severely underestimates the number of actual cases. We leverage delay embedding theorems of Whitney and Takens and use Gaussian process regression to estimate the number of cases during the first 2020 wave based on the second wave of the epidemic in several European countries, South Korea and Brazil. We assume that the second wave was more accurately monitored, even though we acknowledge that behavioural changes occurred during the pandemic and region- (or country-) specific monitoring protocols evolved. We then construct a manifold diffeomorphic to that of the implied original dynamical system, using fatalities or hospitalizations only. Finally, we restrict the diffeomorphism to the reported cases coordinate of the dynamical system. Our main finding is that in the European countries studied, the actual cases are under-reported by as much as 50%. On the other hand, in South Korea-which had a proactive mitigation approach-a far smaller discrepancy between the actual and reported cases is predicted, with an approximately 18% predicted underestimation. We believe that our backcasting framework is applicable to other epidemic outbreaks where (due to limited or poor quality data) there is uncertainty around the actual cases.
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Affiliation(s)
- G. A. Kevrekidis
- Department of Applied Mathematics and Statistics, Johns Hopkins University, Baltimore, MD 21218, USA
- Department of Mathematics and Statistics, University of Massachusetts Amherst, Amherst, MA 01003, USA
| | - Z. Rapti
- Department of Mathematics and Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61820, USA
| | - Y. Drossinos
- European Commission, Joint Research Centre, I-21027 Ispra (VA), Italy
| | - P. G. Kevrekidis
- Department of Mathematics and Statistics, University of Massachusetts Amherst, Amherst, MA 01003, USA
| | - M. A. Barmann
- Department of Mathematics and Statistics, University of Massachusetts Amherst, Amherst, MA 01003, USA
| | - Q. Y. Chen
- Department of Mathematics and Statistics, University of Massachusetts Amherst, Amherst, MA 01003, USA
| | - J. Cuevas-Maraver
- Grupo de Física No Lineal, Departamento de Física Aplicada I, Universidad de Sevilla. Escuela Politécnica Superior, C/ Virgen de África, 7, 41012 Sevilla, Spain
- Instituto de Matemáticas de la Universidad de Sevilla (IMUS). Edificio Celestino Mutis. Avda. Reina Mercedes s/n, 41012 Sevilla, Spain
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24
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Impact of the COVID-19 Pandemic on Gyne-Oncological Treatment-A Retrospective Single-Center Analysis of a German University Hospital with 30,525 Patients. Healthcare (Basel) 2022; 10:healthcare10122386. [PMID: 36553910 PMCID: PMC9777581 DOI: 10.3390/healthcare10122386] [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: 10/31/2022] [Revised: 11/23/2022] [Accepted: 11/25/2022] [Indexed: 11/29/2022] Open
Abstract
The study pursues the objective of drawing a comparison between the data of gyne-oncology, gynecology, and obstetrics patient collectives of a German university hospital regarding the progression of patient number and corresponding treatment data during the five-year period of 2017-2021 to assess the impact of the COVID-19 pandemic on gyne-oncological treatment. Descriptive assessment is based on data extracted from the database of the hospital controlling system QlikView® for patients hospitalized at the Department of Gynecology and Obstetrics of Marburg University Hospital. Gynecology and gyne-oncology experience a maintained decline in patient number (nGynecology: -6% 2019 to 2020, -5% 2019 to 2021; nGyne-Oncology: -6% 2019 to 2020, -2% 2019 to 2021) with varying effects on the specific gyne-oncological main diagnoses. Treatment parameters remain unchanged in relative assessment, but as gyne-oncology constitutes the dominating revenue contributor in gynecology (35.1% of patients, 52.9% of revenue, 2021), the extent of the decrease in total revenue (-18%, 2019 to 2020, -14%, 2019 to 2021) surpasses the decline in patient number. The study displays a negative impact on the gynecology care situation of a German university hospital for the entire pandemic, with an even greater extent on gyne-oncology. This development not only endangers the quality of medical service provision but collaterally pressurizes gynecology service providers.
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25
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Nixon K, Jindal S, Parker F, Reich NG, Ghobadi K, Lee EC, Truelove S, Gardner L. An evaluation of prospective COVID-19 modelling studies in the USA: from data to science translation. Lancet Digit Health 2022; 4:e738-e747. [PMID: 36150782 PMCID: PMC9489063 DOI: 10.1016/s2589-7500(22)00148-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 06/17/2022] [Accepted: 07/13/2022] [Indexed: 02/06/2023]
Abstract
Infectious disease modelling can serve as a powerful tool for situational awareness and decision support for policy makers. However, COVID-19 modelling efforts faced many challenges, from poor data quality to changing policy and human behaviour. To extract practical insight from the large body of COVID-19 modelling literature available, we provide a narrative review with a systematic approach that quantitatively assessed prospective, data-driven modelling studies of COVID-19 in the USA. We analysed 136 papers, and focused on the aspects of models that are essential for decision makers. We have documented the forecasting window, methodology, prediction target, datasets used, and geographical resolution for each study. We also found that a large fraction of papers did not evaluate performance (25%), express uncertainty (50%), or state limitations (36%). To remedy some of these identified gaps, we recommend the adoption of the EPIFORGE 2020 model reporting guidelines and creating an information-sharing system that is suitable for fast-paced infectious disease outbreak science.
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Affiliation(s)
- Kristen Nixon
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Sonia Jindal
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Felix Parker
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Nicholas G Reich
- School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Kimia Ghobadi
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Elizabeth C Lee
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shaun Truelove
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lauren Gardner
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD, USA.
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26
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Nixon K, Jindal S, Parker F, Marshall M, Reich NG, Ghobadi K, Lee EC, Truelove S, Gardner L. Real-time COVID-19 forecasting: challenges and opportunities of model performance and translation. Lancet Digit Health 2022; 4:e699-e701. [PMID: 36150779 PMCID: PMC9499327 DOI: 10.1016/s2589-7500(22)00167-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/22/2022] [Accepted: 08/11/2022] [Indexed: 11/10/2022]
Affiliation(s)
- Kristen Nixon
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Sonia Jindal
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Felix Parker
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Maximilian Marshall
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Nicholas G Reich
- School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Kimia Ghobadi
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Elizabeth C Lee
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shaun Truelove
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lauren Gardner
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD 21218, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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27
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Cereda G, Viscardi C, Baccini M. Combining and comparing regional SARS-CoV-2 epidemic dynamics in Italy: Bayesian meta-analysis of compartmental models and global sensitivity analysis. Front Public Health 2022; 10:919456. [PMID: 36187637 PMCID: PMC9523586 DOI: 10.3389/fpubh.2022.919456] [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: 04/13/2022] [Accepted: 08/10/2022] [Indexed: 01/22/2023] Open
Abstract
During autumn 2020, Italy faced a second important SARS-CoV-2 epidemic wave. We explored the time pattern of the instantaneous reproductive number, R 0(t), and estimated the prevalence of infections by region from August to December calibrating SIRD models on COVID-19-related deaths, fixing at values from literature Infection Fatality Rate (IFR) and average infection duration. A Global Sensitivity Analysis (GSA) was performed on the regional SIRD models. Then, we used Bayesian meta-analysis and meta-regression to combine and compare the regional results and investigate their heterogeneity. The meta-analytic R 0(t) curves were similar in the Northern and Central regions, while a less peaked curve was estimated for the South. The maximum R 0(t) ranged from 2.15 (South) to 2.61 (North) with an increase following school reopening and a decline at the end of October. The predictive performance of the regional models, assessed through cross validation, was good, with a Mean Absolute Percentage Error of 7.2% and 10.9% when considering prediction horizons of 7 and 14 days, respectively. Average temperature, urbanization, characteristics of family medicine and healthcare system, economic dynamism, and use of public transport could partly explain the regional heterogeneity. The GSA indicated the robustness of the regional R 0(t) curves to different assumptions on IFR. The infectious period turned out to have a key role in determining the model results, but without compromising between-region comparisons.
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Affiliation(s)
- Giulia Cereda
- Department of Statistics, Computer Science, Applications, University of Florence, Florence, Italy,Florence Center for Data Science, University of Florence, Florence, Italy,*Correspondence: Giulia Cereda
| | - Cecilia Viscardi
- Department of Statistics, Computer Science, Applications, University of Florence, Florence, Italy,Florence Center for Data Science, University of Florence, Florence, Italy,Cecilia Viscardi
| | - Michela Baccini
- Department of Statistics, Computer Science, Applications, University of Florence, Florence, Italy,Florence Center for Data Science, University of Florence, Florence, Italy,Michela Baccini
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28
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Kimani TN, Nyamai M, Owino L, Makori A, Ombajo LA, Maritim M, Anzala O, Thumbi SM. Infectious disease modelling for SARS-CoV-2 in Africa to guide policy: A systematic review. Epidemics 2022; 40:100610. [PMID: 35868211 PMCID: PMC9281458 DOI: 10.1016/j.epidem.2022.100610] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 06/13/2022] [Accepted: 07/12/2022] [Indexed: 01/21/2023] Open
Abstract
Applied epidemiological models have played a critical role in understanding the transmission and control of disease outbreaks. Their utility and accuracy in decision-making on appropriate responses during public health emergencies is however a factor of their calibration to local data, evidence informing model assumptions, speed of obtaining and communicating their results, ease of understanding and willingness by policymakers to use their insights. We conducted a systematic review of infectious disease models focused on SARS-CoV-2 in Africa to determine: a) spatial and temporal patterns of SARS-CoV-2 modelling in Africa, b) use of local data to calibrate the models and local expertise in modelling activities, and c) key modelling questions and policy insights. We searched PubMed, Embase, Web of Science and MedRxiv databases following the PRISMA guidelines to obtain all SARS-CoV-2 dynamic modelling papers for one or multiple African countries. We extracted data on countries studied, authors and their affiliations, modelling questions addressed, type of models used, use of local data to calibrate the models, and model insights for guiding policy decisions. A total of 74 papers met the inclusion criteria, with nearly two-thirds of these coming from 6% (3) of the African countries. Initial papers were published 2 months after the first cases were reported in Africa, with most papers published after the first wave. More than half of all papers (53, 78%) and (48, 65%) had a first and last author affiliated to an African institution respectively, and only 12% (9) used local data for model calibration. A total of 60% (46) of the papers modelled assessment of control interventions. The transmission rate parameter was found to drive the most uncertainty in the sensitivity analysis for majority of the models. The use of dynamic models to draw policy insights was crucial and therefore there is need to increase modelling capacity in the continent.
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Affiliation(s)
- Teresia Njoki Kimani
- KAVI-Institute of Clinical Research, University of Nairobi, Kenya; Center for Epidemiological Modelling and Analysis, University of Nairobi, Kenya; Paul G Allen School for Global Animal Health, Washington State University, United States; Ministry of Health Kenya, Kiambu County, Kenya.
| | - Mutono Nyamai
- Center for Epidemiological Modelling and Analysis, University of Nairobi, Kenya; Paul G Allen School for Global Animal Health, Washington State University, United States; Institute of Tropical and Infectious Diseases, University of Nairobi, Kenya
| | - Lillian Owino
- Center for Epidemiological Modelling and Analysis, University of Nairobi, Kenya; Institute of Tropical and Infectious Diseases, University of Nairobi, Kenya
| | - Anita Makori
- Center for Epidemiological Modelling and Analysis, University of Nairobi, Kenya; Paul G Allen School for Global Animal Health, Washington State University, United States; Institute of Tropical and Infectious Diseases, University of Nairobi, Kenya
| | - Loice Achieng Ombajo
- Center for Epidemiological Modelling and Analysis, University of Nairobi, Kenya; Department of Clinical Medicine and Therapeutics, University of Nairobi, Kenya
| | - MaryBeth Maritim
- Department of Clinical Medicine and Therapeutics, University of Nairobi, Kenya
| | - Omu Anzala
- KAVI-Institute of Clinical Research, University of Nairobi, Kenya
| | - S M Thumbi
- Center for Epidemiological Modelling and Analysis, University of Nairobi, Kenya; Paul G Allen School for Global Animal Health, Washington State University, United States; Institute of Tropical and Infectious Diseases, University of Nairobi, Kenya; Department of Clinical Medicine and Therapeutics, University of Nairobi, Kenya; South African Center for Epidemiological Modelling and Analysis, South Africa; Institute of Immunology and Infection Research, University of Edinburgh, Scotland
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29
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Ezanno P, Picault S, Bareille S, Beaunée G, Boender GJ, Dankwa EA, Deslandes F, Donnelly CA, Hagenaars TJ, Hayes S, Jori F, Lambert S, Mancini M, Munoz F, Pleydell DRJ, Thompson RN, Vergu E, Vignes M, Vergne T. The African swine fever modelling challenge: Model comparison and lessons learnt. Epidemics 2022; 40:100615. [PMID: 35970067 DOI: 10.1016/j.epidem.2022.100615] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 06/29/2022] [Accepted: 07/20/2022] [Indexed: 11/26/2022] Open
Abstract
Robust epidemiological knowledge and predictive modelling tools are needed to address challenging objectives, such as: understanding epidemic drivers; forecasting epidemics; and prioritising control measures. Often, multiple modelling approaches can be used during an epidemic to support effective decision making in a timely manner. Modelling challenges contribute to understanding the pros and cons of different approaches and to fostering technical dialogue between modellers. In this paper, we present the results of the first modelling challenge in animal health - the ASF Challenge - which focused on a synthetic epidemic of African swine fever (ASF) on an island. The modelling approaches proposed by five independent international teams were compared. We assessed their ability to predict temporal and spatial epidemic expansion at the interface between domestic pigs and wild boar, and to prioritise a limited number of alternative interventions. We also compared their qualitative and quantitative spatio-temporal predictions over the first two one-month projection phases of the challenge. Top-performing models in predicting the ASF epidemic differed according to the challenge phase, host species, and in predicting spatial or temporal dynamics. Ensemble models built using all team-predictions outperformed any individual model in at least one phase. The ASF Challenge demonstrated that accounting for the interface between livestock and wildlife is key to increasing our effectiveness in controlling emerging animal diseases, and contributed to improving the readiness of the scientific community to face future ASF epidemics. Finally, we discuss the lessons learnt from model comparison to guide decision making.
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Affiliation(s)
| | | | - Servane Bareille
- INRAE, Oniris, BIOEPAR, 44300 Nantes, France; INRAE, ENVT, IHAP, Toulouse, France
| | | | | | | | | | - Christl A Donnelly
- Department of Statistics, University of Oxford, Oxford, United Kingdom; Department of Infectious Disease Epidemiology, Faculty of Medicine, School of Public Health, Imperial College London, United Kingdom
| | | | - Sarah Hayes
- Department of Infectious Disease Epidemiology, Faculty of Medicine, School of Public Health, Imperial College London, United Kingdom
| | - Ferran Jori
- CIRAD, INRAE, Université de Montpellier, ASTRE, 34398 Montpellier, France
| | - Sébastien Lambert
- Centre for Emerging, Endemic and Exotic Diseases, Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, United Kingdom
| | - Matthieu Mancini
- INRAE, Oniris, BIOEPAR, 44300 Nantes, France; INRAE, ENVT, IHAP, Toulouse, France
| | - Facundo Munoz
- CIRAD, INRAE, Université de Montpellier, ASTRE, 34398 Montpellier, France
| | - David R J Pleydell
- CIRAD, INRAE, Université de Montpellier, ASTRE, 34398 Montpellier, France
| | - Robin N Thompson
- Mathematics Institute and Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research, University of Warwick, Coventry, United Kingdom
| | - Elisabeta Vergu
- Université Paris-Saclay, INRAE, MaIAGE, 78350 Jouy-en-Josas, France
| | - Matthieu Vignes
- School of Mathematical and Computational Sciences, Massey University, Palmerston North, New Zealand
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30
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On the role of data, statistics and decisions in a pandemic. ASTA ADVANCES IN STATISTICAL ANALYSIS 2022; 106:349-382. [PMID: 35432617 PMCID: PMC8988552 DOI: 10.1007/s10182-022-00439-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 03/09/2022] [Indexed: 12/03/2022]
Abstract
A pandemic poses particular challenges to decision-making because of the need to continuously adapt decisions to rapidly changing evidence and available data. For example, which countermeasures are appropriate at a particular stage of the pandemic? How can the severity of the pandemic be measured? What is the effect of vaccination in the population and which groups should be vaccinated first? The process of decision-making starts with data collection and modeling and continues to the dissemination of results and the subsequent decisions taken. The goal of this paper is to give an overview of this process and to provide recommendations for the different steps from a statistical perspective. In particular, we discuss a range of modeling techniques including mathematical, statistical and decision-analytic models along with their applications in the COVID-19 context. With this overview, we aim to foster the understanding of the goals of these modeling approaches and the specific data requirements that are essential for the interpretation of results and for successful interdisciplinary collaborations. A special focus is on the role played by data in these different models, and we incorporate into the discussion the importance of statistical literacy and of effective dissemination and communication of findings.
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Serrano-Gallardo P, Manzano A, Pawson R. Non-pharmaceutical interventions during COVID-19 in the UK and Spain: a rapid realist review. OPEN RESEARCH EUROPE 2022; 2:52. [PMID: 37645319 PMCID: PMC10446037 DOI: 10.12688/openreseurope.14566.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/08/2022] [Indexed: 08/31/2023]
Abstract
The paper is located at the crossroads of two modern intellectual movements. The first, evidence-based policy, seeks to locate vital information that will inform and improve key policy decisions on such matters as population health, social welfare, and human wellbeing. The second, complexity theory, describes the nature of the social world and perceives human action as persistently adaptive and social institutions as incessantly self-transformative. The first assumes that policies and programmes can achieve sufficient control to meet specific and measurable objectives. The second assumes that social actions are sufficiently capricious so that the society never conforms to anyone's plans - even those of the most powerful. The unparalleled resources committed to control the unprecedented attack of the COVID-19 pandemic are the epitome of complexity. The long struggle to contain the virus thus constitutes an ideal test bed to investigate this paradigmatic split. The paper undertakes this mission - focusing specifically on the effectiveness non-pharmaceutical interventions and examining evidence from the UK and Spain.
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Affiliation(s)
| | - Ana Manzano
- School of Sociology and Social Policy, University of Leeds, Leeds, LS2 9JT, UK
| | - Ray Pawson
- School of Sociology and Social Policy, University of Leeds, Leeds, LS2 9JT, UK
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Hohl HT, Froeschl G, Hoelscher M, Heumann C. Modelling of a triage scoring tool for SARS-COV-2 PCR testing in health-care workers: data from the first German COVID-19 Testing Unit in Munich. BMC Infect Dis 2022; 22:664. [PMID: 35915394 PMCID: PMC9341161 DOI: 10.1186/s12879-022-07627-5] [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: 03/15/2022] [Accepted: 07/14/2022] [Indexed: 11/30/2022] Open
Abstract
Background Numerous scoring tools have been developed for assessing the probability of SARS-COV-2 test positivity, though few being suitable or adapted for outpatient triage of health care workers. Methods We retrospectively analysed 3069 patient records of health care workers admitted to the COVID-19 Testing Unit of the Ludwig-Maximilians-Universität of Munich between January 27 and September 30, 2020, for real-time polymerase chain reaction analysis of naso- or oropharyngeal swabs. Variables for a multivariable logistic regression model were collected from self-completed case report forms and selected through stepwise backward selection. Internal validation was conducted by bootstrapping. We then created a weighted point-scoring system from logistic regression coefficients. Results 4076 (97.12%) negative and 121 (2.88%) positive test results were analysed. The majority were young (mean age: 38.0), female (69.8%) and asymptomatic (67.8%). Characteristics that correlated with PCR-positivity included close-contact professions (physicians, nurses, physiotherapists), flu-like symptoms (e.g., fever, rhinorrhoea, headache), abdominal symptoms (nausea/emesis, abdominal pain, diarrhoea), less days since symptom onset, and contact to a SARS-COV-2 positive index-case. Variables selected for the final model included symptoms (fever, cough, abdominal pain, anosmia/ageusia) and exposures (to SARS-COV-positive individuals and, specifically, to positive patients). Internal validation by bootstrapping yielded a corrected Area Under the Receiver Operating Characteristics Curve of 76.43%. We present sensitivity and specificity at different prediction cut-off points. In a subgroup with further workup, asthma seems to have a protective effect with regard to testing result positivity and measured temperature was found to be less predictive than anamnestic fever. Conclusions We consider low threshold testing for health care workers a valuable strategy for infection control and are able to provide an easily applicable triage score for the assessment of the probability of infection in health care workers in case of resource scarcity. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07627-5.
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Affiliation(s)
- Hannah Tuulikki Hohl
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Leopoldstr. 5, 80802, Munich, Germany.
| | - Guenter Froeschl
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Leopoldstr. 5, 80802, Munich, Germany.,German Center for Infection Research (DZIF), Partner Site Munich, 80802, Munich, Germany
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Leopoldstr. 5, 80802, Munich, Germany.,German Center for Infection Research (DZIF), Partner Site Munich, 80802, Munich, Germany
| | - Christian Heumann
- Department of Statistics, University of Munich (LMU), Ludwigstr. 33, 80539, Munich, Germany
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Darden ME, Dowdy D, Gardner L, Hamilton BH, Kopecky K, Marx M, Papageorge NW, Polsky D, Powers KA, Stuart EA, Zahn MV. Modeling to inform economy-wide pandemic policy: Bringing epidemiologists and economists together. HEALTH ECONOMICS 2022; 31:1291-1295. [PMID: 35501956 PMCID: PMC9325053 DOI: 10.1002/hec.4527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/06/2022] [Indexed: 06/14/2023]
Affiliation(s)
- Michael E. Darden
- Carey School of BusinessJohns Hopkins UniversityBaltimoreMarylandUSA
| | - David Dowdy
- Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Lauren Gardner
- Department of Civil and Systems EngineeringJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Barton H. Hamilton
- Olin Business SchoolWashington University in St. LouisSt. LouisMissouriUSA
| | | | - Melissa Marx
- Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMarylandUSA
| | | | - Daniel Polsky
- Carey School of BusinessJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Kimberly A. Powers
- Gillings School of Global Public HealthUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Elizabeth A. Stuart
- Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Matthew V. Zahn
- Department of EconomicsJohns Hopkins UniversityBaltimoreMarylandUSA
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Johnson K, Biddell CB, Hassmiller Lich K, Swann J, Delamater P, Mayorga M, Ivy J, Smith RL, Patel MD. Use of Modeling to Inform Decision Making in North Carolina during the COVID-19 Pandemic: A Qualitative Study. MDM Policy Pract 2022; 7:23814683221116362. [PMID: 35923388 PMCID: PMC9340948 DOI: 10.1177/23814683221116362] [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: 03/21/2021] [Accepted: 07/05/2022] [Indexed: 11/17/2022] Open
Abstract
Background. The COVID-19 pandemic has popularized computer-based decision-support models, which are commonly used to inform decision making amidst complexity. Understanding what organizational decision makers prefer from these models is needed to inform model development during this and future crises. Methods. We recruited and interviewed decision makers from North Carolina across 9 sectors to understand organizational decision-making processes during the first year of the COVID-19 pandemic (N = 44). For this study, we identified and analyzed a subset of responses from interviewees (n = 19) who reported using modeling to inform decision making. We used conventional content analysis to analyze themes from this convenience sample with respect to the source of models and their applications, the value of modeling and recommended applications, and hesitancies toward the use of models. Results. Models were used to compare trends in disease spread across localities, estimate the effects of social distancing policies, and allocate scarce resources, with some interviewees depending on multiple models. Decision makers desired more granular models, capable of projecting disease spread within subpopulations and estimating where local outbreaks could occur, and incorporating a broad set of outcomes, such as social well-being. Hesitancies to the use of modeling included doubts that models could reflect nuances of human behavior, concerns about the quality of data used in models, and the limited amount of modeling specific to the local context. Conclusions. Decision makers perceived modeling as valuable for informing organizational decisions yet described varied ability and willingness to use models for this purpose. These data present an opportunity to educate organizational decision makers on the merits of decision-support modeling and to inform modeling teams on how to build more responsive models that address the needs of organizational decision makers.
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Affiliation(s)
- Karl Johnson
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Caitlin B. Biddell
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kristen Hassmiller Lich
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Julie Swann
- Department of Industrial and Systems Engineering, North Carolina State University, Atlanta, GA, USA
| | - Paul Delamater
- Department of Geography, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Maria Mayorga
- Department of Industrial and Systems Engineering, North Carolina State University, Atlanta, GA, USA
| | - Julie Ivy
- Department of Industrial and Systems Engineering, North Carolina State University, Atlanta, GA, USA
| | - Raymond L. Smith
- Department of Engineering, College of Engineering and Technology, East Carolina University, Greenville, NC, USA
| | - Mehul D. Patel
- Department of Emergency Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Mustavee S, Agarwal S, Enyioha C, Das S. A linear dynamical perspective on epidemiology: interplay between early COVID-19 outbreak and human mobility. NONLINEAR DYNAMICS 2022; 109:1233-1252. [PMID: 35540628 PMCID: PMC9070110 DOI: 10.1007/s11071-022-07469-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 04/19/2022] [Indexed: 06/14/2023]
Abstract
This paper investigates the impact of human activity and mobility (HAM) in the spreading dynamics of an epidemic. Specifically, it explores the interconnections between HAM and its effect on the early spread of the COVID-19 virus. During the early stages of the pandemic, effective reproduction numbers exhibited a high correlation with human mobility patterns, leading to a hypothesis that the HAM system can be studied as a coupled system with disease spread dynamics. This study applies the generalized Koopman framework with control inputs to determine the nonlinear disease spread dynamics and the input-output characteristics as a locally linear controlled dynamical system. The approach solely relies on the snapshots of spatiotemporal data and does not require any knowledge of the system's underlying physical laws. We exploit the Koopman operator framework by utilizing the Hankel dynamic mode decomposition with Control (HDMDc) algorithm to obtain a linear disease spread model incorporating human mobility as a control input. The study demonstrated that the proposed methodology could capture the impact of local mobility on the early dynamics of the ongoing global pandemic. The obtained locally linear model can accurately forecast the number of new infections for various prediction windows ranging from two to four weeks. The study corroborates a leader-follower relationship between mobility and disease spread dynamics. In addition, the effect of delay embedding in the HDMDc algorithm is also investigated and reported. A case study was performed using COVID infection data from Florida, US, and HAM data extracted from Google community mobility data report.
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Affiliation(s)
- Shakib Mustavee
- Department of Civil Engineering, University of Central Florida, Orlando, FL 32816 USA
| | - Shaurya Agarwal
- Department of Civil Engineering, University of Central Florida, Orlando, FL 32816 USA
| | - Chinwendu Enyioha
- Department of Electrical and Computer Engineering, University of Central Florida, Orlando, FL 32816 USA
| | - Suddhasattwa Das
- Department of Mathematical Sciences, George Mason, University, Fairfax, VA 22030 USA
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Pouwels XGLV, Sampson CJ, Arnold RJG. Opportunities and Barriers to the Development and Use of Open Source Health Economic Models: A Survey. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:473-479. [PMID: 35365297 DOI: 10.1016/j.jval.2021.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 09/02/2021] [Accepted: 10/05/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Health economic (HE) models are routinely used to support health policy and resource allocation decisions but are often considered "black boxes" that may be prone to error and bias. Open source models (OSMs) have been advocated to increase the transparency, credibility, and reuse of HE models. Previous studies have demonstrated interest in OSMs among the health economics and outcomes research community, but the number of OSMs remains low. METHODS We conducted an online survey of ISPOR (the leading professional society for health economics and outcomes research) members' perspectives on the usefulness of OSMs and barriers to their development and implementation. RESULTS Respondents (N = 230) included academics (27%), pharmaceutical (or related) industry representatives (23%), health research or consulting representatives (21%), governmental or nonprofit agency representatives (10%), and others (19%). Respondents were generally not familiar with barriers to the development and adoption of OSMs. Most agreed that OSMs would improve transparency (92%), efficiency (76%), and HE model reuse (86%) and promote confidence in using HE models (75%). The use of OSMs by health technology assessment authorities was considered a very important indicator of the usefulness of OSMs by 49% of respondents. Three-quarters of respondents perceived legal concerns and the ability to transfer data as important barriers to the development and use of OSMs. CONCLUSIONS Respondents believe that OSMs could increase the transparency, efficiency, and credibility of HE models, but that several barriers hamper their widespread adoption. Our results suggest that fundamental changes may be needed across the health economics and outcomes research community if OSMs are to become widely adopted.
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Affiliation(s)
- Xavier G L V Pouwels
- Department of Health Technology and Services Research, Faculty of Behavioural, Management, and Social Sciences, University of Twente, Enschede, The Netherlands
| | | | - Renée J G Arnold
- National Institutes of Health/National Heart, Lung, and Blood Institute, Bethesda, MD, USA; Master of Public Health Program, Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Arnold Consultancy & Technology, LLC, New York, NY, USA.
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Oke AS, Bada OI, Rasaq G, Adodo V. Mathematical analysis of the dynamics of COVID-19 in Africa under the influence of asymptomatic cases and re-infection. MATHEMATICAL METHODS IN THE APPLIED SCIENCES 2022; 45:137-149. [PMID: 34908633 PMCID: PMC8661808 DOI: 10.1002/mma.7769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 07/26/2021] [Accepted: 08/07/2021] [Indexed: 06/14/2023]
Abstract
Coronavirus pandemic (COVID-19) hit the world in December 2019, and only less than 5% of the 15 million cases were recorded in Africa. A major call for concern was the significant rise from 2% in May 2020 to 4.67% by the end of July 15, 2020. This drastic increase calls for quick intervention in the transmission and control strategy of COVID-19 in Africa. A mathematical model to theoretically investigate the consequence of ignoring asymptomatic cases on COVID-19 spread in Africa is proposed in this study. A qualitative analysis of the model is carried out with and without re-infection, and the reproduction number is obtained under re-infection. The results indicate that increasing case detection to detect asymptomatically infected individuals will be very effective in containing and reducing the burden of COVID-19 in Africa. In addition, the fact that it has not been confirmed whether a recovered individual can be re-infected or not, then enforcing a living condition where recovered individuals are not allowed to mix with the susceptible or exposed individuals will help in containing the spread of COVID-19.
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Affiliation(s)
- Abayomi Samuel Oke
- Department of Mathematical SciencesAdekunle Ajasin UniversityAkungbaNigeria
- Department of Mathematical and Actuarial ScienceKenyatta UniversityNairobiKenya
| | | | - Ganiyu Rasaq
- Department of Mathematical SciencesAdekunle Ajasin UniversityAkungbaNigeria
| | - Victoria Adodo
- Department of Mathematical SciencesAdekunle Ajasin UniversityAkungbaNigeria
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Raza A, Rafiq M, Awrejcewicz J, Ahmed N, Mohsin M. Dynamical analysis of coronavirus disease with crowding effect, and vaccination: a study of third strain. NONLINEAR DYNAMICS 2022; 107:3963-3982. [PMID: 35002076 PMCID: PMC8726531 DOI: 10.1007/s11071-021-07108-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 11/26/2021] [Indexed: 06/14/2023]
Abstract
Countries affected by the coronavirus epidemic have reported many infected cases and deaths based on world health statistics. The crowding factor, which we named "crowding effects," plays a significant role in spreading the diseases. However, the introduction of vaccines marks a turning point in the rate of spread of coronavirus infections. Modeling both effects is vastly essential as it directly impacts the overall population of the studied region. To determine the peak of the infection curve by considering the third strain, we develop a mathematical model (susceptible-infected-vaccinated-recovered) with reported cases from August 01, 2021, till August 29, 2021. The nonlinear incidence rate with the inclusion of both effects is the best approach to analyze the dynamics. The model's positivity, boundedness, existence, uniqueness, and stability (local and global) are addressed with the help of a reproduction number. In addition, the strength number and second derivative Lyapunov analysis are examined, and the model was found to be asymptotically stable. The suggested parameters efficiently control the active cases of the third strain in Pakistan. It was shown that a systematic vaccination program regulates the infection rate. However, the crowding effect reduces the impact of vaccination. The present results show that the model can be applied to other countries' data to predict the infection rate.
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Affiliation(s)
- Ali Raza
- Department of Mathematics, Government Maulana Zafar Ali Khan Graduate College Wazirabad, Punjab Higher Education Department (PHED), Lahore, 54000 Pakistan
| | - Muhammad Rafiq
- Department of Mathematics, Faculty of Sciences, University of Central Punjab, Lahore, 54500 Pakistan
| | - Jan Awrejcewicz
- Department of Automation, Biomechanics and Mechatronics, Lodz University of Technology, 1/15 Stefanowskiego St., 90-924 Lodz, Poland
| | - Nauman Ahmed
- Department of Mathematics and Statistics, The University of Lahore, Lahore, Pakistan
| | - Muhammad Mohsin
- Department of Mathematics, Technische Universitat Chemnitz, Chemnitz, Germany
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Ibrahim D, Kis Z, Tak K, Papathanasiou MM, Kontoravdi C, Chachuat B, Shah N. Model-Based Planning and Delivery of Mass Vaccination Campaigns against Infectious Disease: Application to the COVID-19 Pandemic in the UK. Vaccines (Basel) 2021; 9:vaccines9121460. [PMID: 34960206 PMCID: PMC8706890 DOI: 10.3390/vaccines9121460] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/24/2021] [Accepted: 12/02/2021] [Indexed: 12/24/2022] Open
Abstract
Vaccination plays a key role in reducing morbidity and mortality caused by infectious diseases, including the recent COVID-19 pandemic. However, a comprehensive approach that allows the planning of vaccination campaigns and the estimation of the resources required to deliver and administer COVID-19 vaccines is lacking. This work implements a new framework that supports the planning and delivery of vaccination campaigns. Firstly, the framework segments and priorities target populations, then estimates vaccination timeframe and workforce requirements, and lastly predicts logistics costs and facilitates the distribution of vaccines from manufacturing plants to vaccination centres. The outcomes from this study reveal the necessary resources required and their associated costs ahead of a vaccination campaign. Analysis of results shows that by integrating demand stratification, administration, and the supply chain, the synergy amongst these activities can be exploited to allow planning and cost-effective delivery of a vaccination campaign against COVID-19 and demonstrates how to sustain high rates of vaccination in a resource-efficient fashion.
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Affiliation(s)
- Dauda Ibrahim
- The Sargent Centre for Process Systems Engineering, Department of Chemical Engineering, Imperial College London, London SW7 2AZ, UK; (Z.K.); (K.T.); (M.M.P.); (C.K.); (B.C.); (N.S.)
- Correspondence:
| | - Zoltán Kis
- The Sargent Centre for Process Systems Engineering, Department of Chemical Engineering, Imperial College London, London SW7 2AZ, UK; (Z.K.); (K.T.); (M.M.P.); (C.K.); (B.C.); (N.S.)
- Department of Chemical and Biological Engineering, The University of Sheffield, Sheffield S1 3JD, UK
| | - Kyungjae Tak
- The Sargent Centre for Process Systems Engineering, Department of Chemical Engineering, Imperial College London, London SW7 2AZ, UK; (Z.K.); (K.T.); (M.M.P.); (C.K.); (B.C.); (N.S.)
| | - Maria M. Papathanasiou
- The Sargent Centre for Process Systems Engineering, Department of Chemical Engineering, Imperial College London, London SW7 2AZ, UK; (Z.K.); (K.T.); (M.M.P.); (C.K.); (B.C.); (N.S.)
| | - Cleo Kontoravdi
- The Sargent Centre for Process Systems Engineering, Department of Chemical Engineering, Imperial College London, London SW7 2AZ, UK; (Z.K.); (K.T.); (M.M.P.); (C.K.); (B.C.); (N.S.)
| | - Benoît Chachuat
- The Sargent Centre for Process Systems Engineering, Department of Chemical Engineering, Imperial College London, London SW7 2AZ, UK; (Z.K.); (K.T.); (M.M.P.); (C.K.); (B.C.); (N.S.)
| | - Nilay Shah
- The Sargent Centre for Process Systems Engineering, Department of Chemical Engineering, Imperial College London, London SW7 2AZ, UK; (Z.K.); (K.T.); (M.M.P.); (C.K.); (B.C.); (N.S.)
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Gonsalves GS, Salomon JA, Thornhill T, Paltiel AD. Adventures in COVID-19 Policy Modeling: Education Edition. Curr HIV/AIDS Rep 2021; 19:94-100. [PMID: 34826066 PMCID: PMC8617548 DOI: 10.1007/s11904-021-00592-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2021] [Indexed: 11/08/2022]
Abstract
Purpose of Review To introduce readers to policy modeling, a multidisciplinary field of quantitative analysis, primarily used to help guide decision-making. This review focuses on the choices facing educational administrators, from K-12 to universities in the USA, as they confronted the COVID-19 pandemic. We survey three key model-based approaches to mitigation of SARS-CoV-2 spread in schools and on university campuses. Recent Findings Frequent testing, coupled with strict attention to behavioral interventions to prevent further transmission can avoid large outbreaks on college campuses. K-12 administrators can greatly reduce the risks of severe outbreaks of COVID-19 in schools through various mitigation measures including classroom infection control, scheduling and cohorting strategies, staff and teacher vaccination, and asymptomatic screening. Summary Safer re-opening of college and university campuses as well as in-person instruction for K-12 students is possible, under many though not all epidemic scenarios if rigorous disease control and screening programs are in place.
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Affiliation(s)
- Gregg S Gonsalves
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, 60 College Street, New Haven, CT, 06520, USA.
- Public Health Modeling Unit, Yale School of Public Health, 350 George Street, New Haven, CT, 06511, USA.
| | - Joshua A Salomon
- Department of Health Policy, Stanford University School of Medicine, 615 Crothers Way, CA, 94305, Stanford, USA
| | - Thomas Thornhill
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, 60 College Street, New Haven, CT, 06520, USA
- Public Health Modeling Unit, Yale School of Public Health, 350 George Street, New Haven, CT, 06511, USA
| | - A David Paltiel
- Public Health Modeling Unit, Yale School of Public Health, 350 George Street, New Haven, CT, 06511, USA
- Department of Health Policy and Management, Yale School of Public Health, 60 College Street, New Haven, CT, 06520, USA
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Rocha Filho TM, Moret MA, Chow CC, Phillips JC, Cordeiro AJA, Scorza FA, Almeida ACG, Mendes JFF. A data-driven model for COVID-19 pandemic - Evolution of the attack rate and prognosis for Brazil. CHAOS, SOLITONS, AND FRACTALS 2021; 152:111359. [PMID: 34483500 PMCID: PMC8405546 DOI: 10.1016/j.chaos.2021.111359] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 08/11/2021] [Indexed: 05/05/2023]
Abstract
We introduce a compartmental model SEIAHRV (Susceptible, Exposed, Infected, Asymptomatic, Hospitalized, Recovered, Vaccinated) with age structure for the spread of the SARAS-CoV virus. In order to model current different vaccines we use compartments for individuals vaccinated with one and two doses without vaccine failure and a compartment for vaccinated individual with vaccine failure. The model allows to consider any number of different vaccines with different efficacies and delays between doses. Contacts among age groups are modeled by a contact matrix and the contagion matrix is obtained from a probability of contagion p c per contact. The model uses known epidemiological parameters and the time dependent probability p c is obtained by fitting the model output to the series of deaths in each locality, and reflects non-pharmaceutical interventions. As a benchmark the output of the model is compared to two good quality serological surveys, and applied to study the evolution of the COVID-19 pandemic in the main Brazilian cities with a total population of more than one million. We also discuss with some detail the case of the city of Manaus which raised special attention due to a previous report of We also estimate the attack rate, the total proportion of cases (symptomatic and asymptomatic) with respect to the total population, for all Brazilian states since the beginning of the COVID-19 pandemic. We argue that the model present here is relevant to assessing present policies not only in Brazil but also in any place where good serological surveys are not available.
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Affiliation(s)
- T M Rocha Filho
- International Center for Condensed Matter Physics and Instituto de Física, Universidade de Brasília, Brasília - BRAZIL
| | - M A Moret
- Centro Universitário SENAI CIMATEC and Universidade do Estado da Bahia, Salvador - Brazil
| | - C C Chow
- Mathematical Biology, NIDDK, NIH, Bethesda, Md 20892 - USA
| | - J C Phillips
- Physics and Astronomy, Rutgers University, Piscataway, NJ 08854 - USA
| | - A J A Cordeiro
- Centro Universitário SENAI CIMATEC, Salvador and Instituto Federal de Educacão e Tecnologia da Bahia, Feira de Santana - Brazil
| | - F A Scorza
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo - Brazil
| | - A-C G Almeida
- Universidade Federal de São João del-Rei, São João del-Rei - Brazil
| | - J F F Mendes
- Departamento de Física and I3N, Universidade de Aveiro, 3880 Aveiro - Portugal
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Albani V, Loria J, Massad E, Zubelli J. COVID-19 underreporting and its impact on vaccination strategies. BMC Infect Dis 2021; 21:1111. [PMID: 34711190 PMCID: PMC8552982 DOI: 10.1186/s12879-021-06780-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 10/05/2021] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Underreporting cases of infectious diseases poses a major challenge in the analysis of their epidemiological characteristics and dynamical aspects. Without accurate numerical estimates it is difficult to precisely quantify the proportions of severe and critical cases, as well as the mortality rate. Such estimates can be provided for instance by testing the presence of the virus. However, during an ongoing epidemic, such tests' implementation is a daunting task. This work addresses this issue by presenting a methodology to estimate underreported infections based on approximations of the stable rates of hospitalization and death. METHODS We present a novel methodology for the stable rate estimation of hospitalization and death related to the Corona Virus Disease 2019 (COVID-19) using publicly available reports from various distinct communities. These rates are then used to estimate underreported infections on the corresponding areas by making use of reported daily hospitalizations and deaths. The impact of underreporting infections on vaccination strategies is estimated under different disease-transmission scenarios using a Susceptible-Exposed-Infective-Removed-like (SEIR) epidemiological model. RESULTS For the considered locations, during the period of study, the estimations suggest that the number of infected individuals could reach 30% of the population of these places, representing, in some cases, more than six times the observed numbers. These results are in close agreement with estimates from independent seroprevalence studies, thus providing a strong validation of the proposed methodology. Moreover, the presence of large numbers of underreported infections can reduce the perceived impact of vaccination strategies in reducing rates of mortality and hospitalization. CONCLUSIONS pBy using the proposed methodology and employing a judiciously chosen data analysis implementation, we estimate COVID-19 underreporting from publicly available data. This leads to a powerful way of quantifying underreporting impact on the efficacy of vaccination strategies. As a byproduct, we evaluate the impact of underreporting in the designing of vaccination strategies.
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Affiliation(s)
- Vinicius Albani
- Department of Mathematics, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Jennifer Loria
- Instituto de Matemática Pura e Aplicada, Rio de Janeiro, Brazil
- Universidad de Costa Rica, San Jose, Costa Rica
| | - Eduardo Massad
- School of Applied Mathematics, Fundação Getúlio Vargas, Rio de Janeiro, Brazil
- School of Medicine, University of São Paulo and LIM01-HCFMUSP, São Paulo, Brazil
| | - Jorge Zubelli
- Mathematics Department, Khalifa University, Abu Dhabi, UAE
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Fields R, Humphrey L, Flynn-Primrose D, Mohammadi Z, Nahirniak M, Thommes E, Cojocaru M. Age-stratified transmission model of COVID-19 in Ontario with human mobility during pandemic's first wave. Heliyon 2021; 7:e07905. [PMID: 34514179 PMCID: PMC8419869 DOI: 10.1016/j.heliyon.2021.e07905] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 04/10/2021] [Accepted: 08/27/2021] [Indexed: 12/15/2022] Open
Abstract
In this work, we employ a data-fitted compartmental model to visualize the progression and behavioral response to COVID-19 that match provincial case data in Ontario, Canada from February to June of 2020. This is a "rear-view mirror" glance at how this region has responded to the 1st wave of the pandemic, when testing was sparse and NPI measures were the only remedy to stave off the pandemic. We use an SEIR-type model with age-stratified subpopulations and their corresponding contact rates and asymptomatic rates in order to incorporate heterogeneity in our population and to calibrate the time-dependent reduction of Ontario-specific contact rates to reflect intervention measures in the province throughout lockdown and various stages of social-distancing measures. Cellphone mobility data taken from Google, combining several mobility categories, allows us to investigate the effects of mobility reduction and other NPI measures on the evolution of the pandemic. Of interest here is our quantification of the effectiveness of Ontario's response to COVID-19 before and after provincial measures and our conclusion that the sharp decrease in mobility has had a pronounced effect in the first few weeks of the lockdown, while its effect is harder to infer once other NPI measures took hold.
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Affiliation(s)
- R. Fields
- Department of Mathematics and Statistics, University of Guelph, Canada
| | - L. Humphrey
- Department of Mathematics and Statistics, University of Guelph, Canada
| | - D. Flynn-Primrose
- Department of Mathematics and Statistics, University of Guelph, Canada
| | - Z. Mohammadi
- Department of Mathematics and Statistics, University of Guelph, Canada
| | - M. Nahirniak
- Department of Mathematics and Statistics, University of Guelph, Canada
| | | | - M.G. Cojocaru
- Department of Mathematics and Statistics, University of Guelph, Canada
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Boschi T, Di Iorio J, Testa L, Cremona MA, Chiaromonte F. Functional data analysis characterizes the shapes of the first COVID-19 epidemic wave in Italy. Sci Rep 2021; 11:17054. [PMID: 34462450 PMCID: PMC8405612 DOI: 10.1038/s41598-021-95866-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 07/27/2021] [Indexed: 12/11/2022] Open
Abstract
We investigate patterns of COVID-19 mortality across 20 Italian regions and their association with mobility, positivity, and socio-demographic, infrastructural and environmental covariates. Notwithstanding limitations in accuracy and resolution of the data available from public sources, we pinpoint significant trends exploiting information in curves and shapes with Functional Data Analysis techniques. These depict two starkly different epidemics; an "exponential" one unfolding in Lombardia and the worst hit areas of the north, and a milder, "flat(tened)" one in the rest of the country-including Veneto, where cases appeared concurrently with Lombardia but aggressive testing was implemented early on. We find that mobility and positivity can predict COVID-19 mortality, also when controlling for relevant covariates. Among the latter, primary care appears to mitigate mortality, and contacts in hospitals, schools and workplaces to aggravate it. The techniques we describe could capture additional and potentially sharper signals if applied to richer data.
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Affiliation(s)
- Tobia Boschi
- Dept. of Statistics and Huck Institutes of the Life Sciences, Penn State University, University Park, PA, 16802, USA
| | - Jacopo Di Iorio
- Institute of Economics and EMbeDS, Sant'Anna School of Advanced Studies, 56127, Pisa, Italy
| | - Lorenzo Testa
- Institute of Economics and EMbeDS, Sant'Anna School of Advanced Studies, 56127, Pisa, Italy
| | - Marzia A Cremona
- Dept. of Statistics and Huck Institutes of the Life Sciences, Penn State University, University Park, PA, 16802, USA. .,Dept. of Operations and Decision Systems, Université Laval, Quebec, G1V 0A6, Canada. .,CHU de Québec - Université Laval Research Center, Quebec, G1V 4G2, Canada.
| | - Francesca Chiaromonte
- Dept. of Statistics and Huck Institutes of the Life Sciences, Penn State University, University Park, PA, 16802, USA. .,Institute of Economics and EMbeDS, Sant'Anna School of Advanced Studies, 56127, Pisa, Italy.
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Revell LJ. covid19.Explorer: a web application and R package to explore United States COVID-19 data. PeerJ 2021; 9:e11489. [PMID: 34484978 PMCID: PMC8381881 DOI: 10.7717/peerj.11489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 04/27/2021] [Indexed: 01/02/2023] Open
Abstract
Appearing at the end of 2019, a novel virus (later identified as SARS-CoV-2) was characterized in the city of Wuhan in Hubei Province, China. As of the time of writing, the disease caused by this virus (known as COVID-19) has already resulted in over three million deaths worldwide. SARS-CoV-2 infections and deaths, however, have been highly unevenly distributed among age groups, sexes, countries, and jurisdictions over the course of the pandemic. Herein, I present a tool (the covid19.Explorer R package and web application) that has been designed to explore and analyze publicly available United States COVID-19 infection and death data from the 2020/21 U.S. SARS-CoV-2 pandemic. The analyses and visualizations that this R package and web application facilitate can help users better comprehend the geographic progress of the pandemic, the effectiveness of non-pharmaceutical interventions (such as lockdowns and other measures, which have varied widely among U.S. states), and the relative risks posed by COVID-19 to different age groups within the U.S. population. The end result is an interactive tool that will help its users develop an improved understanding of the temporal and geographic dynamics of the SARS-CoV-2 pandemic, accessible to lay people and scientists alike.
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Affiliation(s)
- Liam J. Revell
- Department of Biology, University of Massachusetts at Boston, Boston, MA, USA
- Facultad de Ciencias, Universidad Católica de la Santísima Concepción, Concepción, Chile
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Lee SAK, Laefer DF. Spring 2020 COVID-19 community transmission behaviours around New York City medical facilities. Infect Prev Pract 2021; 3:100158. [PMID: 34316553 PMCID: PMC8233409 DOI: 10.1016/j.infpip.2021.100158] [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: 02/05/2021] [Accepted: 06/16/2021] [Indexed: 11/08/2022] Open
Abstract
Background Epidemiological studies have long been used for infection transmission prevention, but exact patterns of touch behaviours and transportation choices [contributors to community spread of coronavirus disease 2019 (COVID-19)] were previously unknown. Aim To investigate individual risk behaviour levels with respect to local COVID-19 infection levels. Methods A longitudinal field study recorded behaviours of individuals leaving medical facilities following the New York State's PAUSE order. A subset of those data was analysed herein (4793 records, 16 facilities, 23rd March–17th May 2020). Touched objects and transportation choices were compared over time using Chi-squared tests (P<0.05 significance threshold). Findings In Week 1, 64.1% of subjects touched at least one environmental object [such as a building door handle (21.8%); traffic light, railing or parking meter (5.6%)]; shared object [such as a vehicle door handle (19.7%)]; personal object [such as a cell phone (4.2%)]; or themselves (0.4%). By Week 8, <35% of subjects touched at least one object, where the greatest reduction was in touching environmental objects. The frequency of touching increased slightly during the observation period for some personal objects such as cell phones. The use of public transportation remained steady (approximately 20%) throughout the study period; for-hire vehicle usage increased from 0% in Week 1 to 7% in Week 8, mirroring a 7% decrease in the use of personal vehicles (from 34% to 27%). Touching and transportation patterns varied significantly by facility. Conclusions While this study observed a decline in touch patterns and use of shared modes of transportation, the persistence of many risk-related behaviours suggests that more effective public health policies, including cleaning regimens for public environmental objects and the removal or relocation of frequently touched objects, could help limit the spread of COVID-19.
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Affiliation(s)
- S-A Kingsbury Lee
- Center for Urban Science + Progress, New York University, Brooklyn, NY, USA
| | - D F Laefer
- Center for Urban Science + Progress, New York University, Brooklyn, NY, USA
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Lokot M, Bhatia A, Heidari S, Peterman A. The pitfalls of modelling the effects of COVID-19 on gender-based violence: lessons learnt and ways forward. BMJ Glob Health 2021; 6:bmjgh-2021-005739. [PMID: 33947710 PMCID: PMC8098229 DOI: 10.1136/bmjgh-2021-005739] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 11/04/2022] Open
Abstract
Since early 2020, global stakeholders have highlighted the significant gendered consequences of the COVID-19 pandemic, including increases in the risk of gender-based violence (GBV). Researchers have sought to inform the pandemic response through a diverse set of methodologies, including early efforts modelling anticipated increases in GBV. For example, in April 2020, a highly cited modelling effort by the United Nations Population Fund (UNFPA) and partners projected headline global figures of 31 million additional cases of intimate partner violence due to 6 months of lockdown, and an additional 13 million child marriages by 2030. In this paper, we discuss the rationale for using modelling to make projections about GBV, and use the projections released by UNFPA to draw attention to the assumptions and biases underlying model-based projections. We raise five key critiques: (1) reducing complex issues to simplified, linear cause-effect relationships, (2) reliance on a small number of studies to generate global estimates, (3) assuming that the pandemic results in the complete service disruption for existing interventions, (4) lack of clarity in indicators used and sources of estimates, and (5) failure to account for margins of uncertainty. We argue that there is a need to consider the motivations and consequences of using modelling data as a planning tool for complex issues like GBV, and conclude by suggesting key considerations for policymakers and practitioners in using and commissioning such projections.
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Affiliation(s)
- Michelle Lokot
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Amiya Bhatia
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Shirin Heidari
- Global Health Centre, Graduate Institute of International and Development Studies, Geneve, Switzerland.,GENDRO, Geneva, Switzerland
| | - Amber Peterman
- Department of Public Policy, University of North Carolina, Chapel Hill, North Carolina, USA
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Carvalho T, Cristiano R, Rodrigues DS, Tonon DJ. Global Analysis of a piecewise smooth epidemiological model of COVID-19. NONLINEAR DYNAMICS 2021; 105:3763-3773. [PMID: 34456509 PMCID: PMC8384106 DOI: 10.1007/s11071-021-06801-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 08/04/2021] [Indexed: 05/09/2023]
Abstract
Despite the huge relevance of vaccines for preventing COVID-19, physical isolation and quarantine of infected individuals are still the key strategies to fight against the COVID-19 pandemic. Based on a COVID-19 transmission epidemiological model governed by ordinary differential equations, here we propose an intermittent non-pharmacological protocol to control the fraction of infected individuals. In our approach, unlike what generically happens for numerical simulation models, we provide a global analysis of the model, giving qualitative information about every initial condition. Under some simple hypothesis and variations of parameters, we present some bifurcations and we are able to predict the minimum social distancing effort that do not collapse the health system.
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Affiliation(s)
- Tiago Carvalho
- Department of Computing and Mathematics, Faculty of Philosophy, Sciences and Letters of Ribeirão Preto, Univ. of São Paulo, 14040-901 Ribeirão Preto, SP Brazil
| | - Rony Cristiano
- Institute of Mathematics and Statistics, Federal University of Goiás, Avenida Esperança s/n, Campus Samambaia, 74690-900 Goiânia, Goiás Brazil
| | - Diego S. Rodrigues
- School of Technology, University of Campinas, R. Paschoal Marmo, 1888, 13484-332 Limeira, SP Brazil
| | - Durval J. Tonon
- Institute of Mathematics and Statistics, Federal University of Goiás, Avenida Esperança s/n, Campus Samambaia, 74690-900 Goiânia, Goiás Brazil
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