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Kundzewicz ZW, Ebi KL, Duszyński J. Lessons from the COVID-19 pandemic: Mortality impacts in Poland versus European Union. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2023. [PMID: 38030383 DOI: 10.1111/risa.14259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 11/14/2023] [Accepted: 11/15/2023] [Indexed: 12/01/2023]
Abstract
With COVID-19 moving toward an endemic phase, it is worthwhile to identify lessons from the pandemic that can promote the effective strengthening of national health systems. We look at a single country, Poland, and compare it with the European Union (EU) to contrast approaches and outcomes. Among possible relevant indices, we examine characteristics of COVID-19-related mortality and excess all-cause mortality from March 2020 to February 2022. We demonstrate that both the numbers of COVID-related deaths and all-cause deaths in Poland were much higher than the EU average for most months in the study period. We juxtapose the percentage of fully vaccinated population and cumulative COVID-19 deaths per million people for EU Member States and show that typically higher vaccination rates are accompanied by lower mortality. We also show that, in addition to medical science, the use of a risk science toolbox would have been valuable in the management of the COVID-19 pandemic in Poland. Better and more widespread understanding of risk perception of the pandemic and the COVID-19 vaccines would have improved managing vaccine hesitancy, potentially leading to more effective pro-vaccination measures.
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Affiliation(s)
- Zbigniew W Kundzewicz
- Faculty of Environmental Engineering and Mechanical Engineering, Poznan University of Life Sciences, Poznan, Poland
| | - Kristie L Ebi
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Jerzy Duszyński
- Nencki Institute of Experimental Biology of Polish Academy of Sciences, Warsaw, Poland
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2
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Murphy C, Lim WW, Mills C, Wong JY, Chen D, Xie Y, Li M, Gould S, Xin H, Cheung JK, Bhatt S, Cowling BJ, Donnelly CA. Effectiveness of social distancing measures and lockdowns for reducing transmission of COVID-19 in non-healthcare, community-based settings. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2023; 381:20230132. [PMID: 37611629 PMCID: PMC10446910 DOI: 10.1098/rsta.2023.0132] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 05/23/2023] [Indexed: 08/25/2023]
Abstract
Social distancing measures (SDMs) are community-level interventions that aim to reduce person-to-person contacts in the community. SDMs were a major part of the responses first to contain, then to mitigate, the spread of SARS-CoV-2 in the community. Common SDMs included limiting the size of gatherings, closing schools and/or workplaces, implementing work-from-home arrangements, or more stringent restrictions such as lockdowns. This systematic review summarized the evidence for the effectiveness of nine SDMs. Almost all of the studies included were observational in nature, which meant that there were intrinsic risks of bias that could have been avoided were conditions randomly assigned to study participants. There were no instances where only one form of SDM had been in place in a particular setting during the study period, making it challenging to estimate the separate effect of each intervention. The more stringent SDMs such as stay-at-home orders, restrictions on mass gatherings and closures were estimated to be most effective at reducing SARS-CoV-2 transmission. Most studies included in this review suggested that combinations of SDMs successfully slowed or even stopped SARS-CoV-2 transmission in the community. However, individual effects and optimal combinations of interventions, as well as the optimal timing for particular measures, require further investigation. This article is part of the theme issue 'The effectiveness of non-pharmaceutical interventions on the COVID-19 pandemic: the evidence'.
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Affiliation(s)
- Caitriona Murphy
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Wey Wen Lim
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Cathal Mills
- Department of Statistics, University of Oxford, Oxford, UK
| | - Jessica Y. Wong
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Dongxuan Chen
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
- Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, New Territories, Hong Kong, People's Republic of China
| | - Yanmy Xie
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Mingwei Li
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
- Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, New Territories, Hong Kong, People's Republic of China
| | - Susan Gould
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Tropical and Infectious Disease Unit, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Hualei Xin
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Justin K. Cheung
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Samir Bhatt
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Kobenhavn, Denmark
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, UK
| | - Benjamin J. Cowling
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
- Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, New Territories, Hong Kong, People's Republic of China
| | - Christl A. Donnelly
- Department of Statistics, University of Oxford, Oxford, UK
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, UK
- Pandemic Sciences Institute, University of Oxford, Oxford, UK
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Liossi S, Tsiambas E, Maipas S, Papageorgiou E, Lazaris A, Kavantzas N. Mathematical modeling for Delta and Omicron variant of SARS-CoV-2 transmission dynamics in Greece. Infect Dis Model 2023; 8:794-805. [PMID: 37496829 PMCID: PMC10366468 DOI: 10.1016/j.idm.2023.07.002] [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: 04/26/2023] [Revised: 07/02/2023] [Accepted: 07/05/2023] [Indexed: 07/28/2023] Open
Abstract
A compartmental, epidemiological, mathematical model was developed in order to analyze the transmission dynamics of Delta and Omicron variant, of SARS-CoV-2, in Greece. The model was parameterized twice during the 4th and 5th wave of the pandemic. The 4th wave refers to the period during which the Delta variant was dominant (approximately July to December of 2021) and the 5th wave to the period during which the Omicron variant was dominant (approximately January to May of 2022), in accordance with the official data from the National Public Health Organization (NPHO). Fitting methods were applied to evaluate important parameters in connection with the transmission of the variants, as well as the social behavior of population during these periods of interest. Mathematical models revealed higher numbers of contagiousness and cases of asymptomatic disease during the Omicron variant period, but a decreased rate of hospitalization compared to the Delta period. Also, parameters related to the behavior of the population in Greece were also assessed. More specifically, the use of protective masks and the abidance of social distancing measures. Simulations revealed that over 5,000 deaths could have been avoided, if mask usage and social distancing were 20% more efficient, during the short period of the Delta and Omicron outbreak. Furthermore, the spread of the variants was assessed using viral load data. The data were recorded from PCR tests at 417 Army Equity Fund Hospital (NIMTS), in Athens and the Ct values from 746 patients with COVID-19 were processed, to explain transmission phenomena and disease severity in patients. The period when the Delta variant prevailed in the country, the average Ct value was calculated as 25.19 (range: 12.32-39.29), whereas during the period when the Omicron variant prevailed, the average Ct value was calculated as 28 (range: 14.41-39.36). In conclusion, our experimental study showed that the higher viral load, which is related to the Delta variant, may interpret the severity of the disease. However, no correlation was confirmed regarding contagiousness phenomena. The results of the model, Ct analysis and official data from NPHO are consistent.
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Affiliation(s)
- Sofia Liossi
- 1st Department of Pathology, School of Medicine, National and Kapodistrian University of Athens, Athens General Hospital “Laikon”, Athens, Greece
| | - E. Tsiambas
- Department of Cytopathology, 417 Army Equity Fund Hospital (NIMTS), Athens, Greece
| | - S. Maipas
- 1st Department of Pathology, School of Medicine, National and Kapodistrian University of Athens, Athens General Hospital “Laikon”, Athens, Greece
- Master Program “Environment and Health. Management of Environmental Health Effects”, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - E. Papageorgiou
- Department of Biomedical Sciences, School of Health & Welfare Sciences, University of West Attica, Egaleo, Greece
| | - A. Lazaris
- 1st Department of Pathology, School of Medicine, National and Kapodistrian University of Athens, Athens General Hospital “Laikon”, Athens, Greece
- Master Program “Environment and Health. Management of Environmental Health Effects”, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - N. Kavantzas
- 1st Department of Pathology, School of Medicine, National and Kapodistrian University of Athens, Athens General Hospital “Laikon”, Athens, Greece
- Master Program “Environment and Health. Management of Environmental Health Effects”, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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4
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Wong KLM, Gimma A, Coletti P, Faes C, Beutels P, Hens N, Jaeger VK, Karch A, Johnson H, Edmunds WJ, Jarvis CI. Social contact patterns during the COVID-19 pandemic in 21 European countries - evidence from a two-year study. BMC Infect Dis 2023; 23:268. [PMID: 37101123 PMCID: PMC10132446 DOI: 10.1186/s12879-023-08214-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 03/31/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Most countries have enacted some restrictions to reduce social contacts to slow down disease transmission during the COVID-19 pandemic. For nearly two years, individuals likely also adopted new behaviours to avoid pathogen exposure based on personal circumstances. We aimed to understand the way in which different factors affect social contacts - a critical step to improving future pandemic responses. METHODS The analysis was based on repeated cross-sectional contact survey data collected in a standardized international study from 21 European countries between March 2020 and March 2022. We calculated the mean daily contacts reported using a clustered bootstrap by country and by settings (at home, at work, or in other settings). Where data were available, contact rates during the study period were compared with rates recorded prior to the pandemic. We fitted censored individual-level generalized additive mixed models to examine the effects of various factors on the number of social contacts. RESULTS The survey recorded 463,336 observations from 96,456 participants. In all countries where comparison data were available, contact rates over the previous two years were substantially lower than those seen prior to the pandemic (approximately from over 10 to < 5), predominantly due to fewer contacts outside the home. Government restrictions imposed immediate effect on contacts, and these effects lingered after the restrictions were lifted. Across countries, the relationships between national policy, individual perceptions, or personal circumstances determining contacts varied. CONCLUSIONS Our study, coordinated at the regional level, provides important insights into the understanding of the factors associated with social contacts to support future infectious disease outbreak responses.
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Affiliation(s)
- Kerry L M Wong
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Amy Gimma
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Pietro Coletti
- Data Science Institute, I-Biostat, Hasselt University, Agoralaan Gebouw D, 3590, Diepenbeek, Belgium
| | - Christel Faes
- Data Science Institute, I-Biostat, Hasselt University, Agoralaan Gebouw D, 3590, Diepenbeek, Belgium
| | - Philippe Beutels
- Centre for Health Economics Research and Modelling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium
- School of Public Health and Community Medicine, The University of New South Wales, Sydney, Australia
| | - Niel Hens
- Data Science Institute, I-Biostat, Hasselt University, Agoralaan Gebouw D, 3590, Diepenbeek, Belgium
- Centre for Health Economics Research and Modelling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium
| | - Veronika K Jaeger
- Institute of Epidemiology and Social Medicine, University of Muenster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Andre Karch
- Institute of Epidemiology and Social Medicine, University of Muenster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Helen Johnson
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - WJohn Edmunds
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Christopher I Jarvis
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
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Contento L, Castelletti N, Raimúndez E, Le Gleut R, Schälte Y, Stapor P, Hinske LC, Hoelscher M, Wieser A, Radon K, Fuchs C, Hasenauer J. Integrative modelling of reported case numbers and seroprevalence reveals time-dependent test efficiency and infectious contacts. Epidemics 2023; 43:100681. [PMID: 36931114 PMCID: PMC10008049 DOI: 10.1016/j.epidem.2023.100681] [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: 10/06/2021] [Revised: 02/28/2023] [Accepted: 03/08/2023] [Indexed: 03/16/2023] Open
Abstract
Mathematical models have been widely used during the ongoing SARS-CoV-2 pandemic for data interpretation, forecasting, and policy making. However, most models are based on officially reported case numbers, which depend on test availability and test strategies. The time dependence of these factors renders interpretation difficult and might even result in estimation biases. Here, we present a computational modelling framework that allows for the integration of reported case numbers with seroprevalence estimates obtained from representative population cohorts. To account for the time dependence of infection and testing rates, we embed flexible splines in an epidemiological model. The parameters of these splines are estimated, along with the other parameters, from the available data using a Bayesian approach. The application of this approach to the official case numbers reported for Munich (Germany) and the seroprevalence reported by the prospective COVID-19 Cohort Munich (KoCo19) provides first estimates for the time dependence of the under-reporting factor. Furthermore, we estimate how the effectiveness of non-pharmaceutical interventions and of the testing strategy evolves over time. Overall, our results show that the integration of temporally highly resolved and representative data is beneficial for accurate epidemiological analyses.
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Affiliation(s)
- Lorenzo Contento
- Faculty of Mathematics and Natural Sciences, University of Bonn, Bonn, Germany.
| | - Noemi Castelletti
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Elba Raimúndez
- Faculty of Mathematics and Natural Sciences, University of Bonn, Bonn, Germany; Center for Mathematics, Technische Universität München, Garching, Germany
| | - Ronan Le Gleut
- Institute of Computational Biology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany; Core Facility Statistical Consulting, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Yannik Schälte
- Institute of Computational Biology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany; Center for Mathematics, Technische Universität München, Garching, Germany
| | - Paul Stapor
- Institute of Computational Biology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany; Center for Mathematics, Technische Universität München, Garching, Germany
| | - Ludwig Christian Hinske
- Institut für medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Munich, Germany
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany; Center for International Health (CIH), University Hospital, LMU Munich, Munich, Germany; German Center for Infection Research (DZIF), partner site Munich, Germany
| | - Andreas Wieser
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany; German Center for Infection Research (DZIF), partner site Munich, Germany
| | - Katja Radon
- German Center for Infection Research (DZIF), partner site Munich, Germany; Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany; Comprehensive Pneumology Center (CPC) Munich, German Center for Lung Research (DZL), Munich, Germany
| | - Christiane Fuchs
- Institute of Computational Biology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany; Core Facility Statistical Consulting, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany; Center for Mathematics, Technische Universität München, Garching, Germany; Faculty of Business Administration and Economics, Bielefeld University, Bielefeld, Germany
| | - Jan Hasenauer
- Faculty of Mathematics and Natural Sciences, University of Bonn, Bonn, Germany; Institute of Computational Biology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany; Center for Mathematics, Technische Universität München, Garching, Germany
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6
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Zambrano KT, Imani M, Cunha DGF. COVID-19 and organisational resilience in Brazil's water sector. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 848:157637. [PMID: 35905969 PMCID: PMC9361783 DOI: 10.1016/j.scitotenv.2022.157637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic required a wide range of adaptations to the way that water sector operated globally. This paper looks into the impact of the COVID-19 pandemic on Brazilian water sector and evaluates the water sector's organisational resilience from the lens of water professionals. This study uses British Standard (BS 65000:2014)'s Resilience Maturity Scale method to evaluate organisational resilience in water sector under two defined scenarios of before and during the pandemic. For this purpose, the self-assessment framework developed by Southern Water in the United Kingdom (based on BS 65000:2014), comprising of the core resilience elements of Direction, Awareness, Alignment, Learning, Strengthening, and Assurance, are used for evaluations. A qualitative-quantitative surveying method is used for data collection. A total of 14 responses to the whole questionnaire were received from May 2021 to August 2021, each representing one water company in Brazil (four local companies and ten state-owned ones). The analyses identified COVID-19 as a threat multiplier particularly to already existing financial challenges due to the pre-existing threats in water sector. Bad debt and the COVID-19 emergency measures are recognised as the main challenges by 21 % and 14 % of the survey respondents. The state-owned and local companies scored an almost similar maturity level 3, 35 % and 34 % respectively, while the local companies scored much lower at maturity level 4 i.e., 26 % as opposed to 47 % in state-owned sector. This indicates that COVID-19 has a greater impact on local companies and the needs to increase preparedness. This study replicates an international experience to raise awareness on water sector's resiliency in Brazil and how it can be improved to withstand future external shocks. It sheds light on how and what existing challenges can be exacerbated facing a global shock and proposes opportunities for improvement of resilience maturity in water sector in Brazil.
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Affiliation(s)
- Karen Tavares Zambrano
- Department of Hydraulics and Sanitation, São Carlos School of Engineering, University of São Paulo, São Carlos, São Paulo CEP 13560-590, Brazil.
| | - Maryam Imani
- School of Engineering & the Built Environment, Faculty of Science and Engineering, Anglia Ruskin University, Chelmsford, Essex CM1 1SQ, United Kingdom.
| | - Davi Gasparini Fernandes Cunha
- Department of Hydraulics and Sanitation, São Carlos School of Engineering, University of São Paulo, São Carlos, São Paulo CEP 13560-590, Brazil.
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Adu PA, Binka M, Mahmood B, Jeong D, Buller-Taylor T, Damascene MJ, Iyaniwura S, Ringa N, Velásquez García HA, Wong S, Yu A, Bartlett S, Wilton J, Irvine MA, Otterstatter M, Janjua NZ. Cohort profile: the British Columbia COVID-19 Population Mixing Patterns Survey (BC-Mix). BMJ Open 2022; 12:e056615. [PMID: 36002217 PMCID: PMC9412046 DOI: 10.1136/bmjopen-2021-056615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
PURPOSE Several non-pharmaceutical interventions, such as physical distancing, handwashing, self-isolation, and school and business closures, were implemented in British Columbia (BC) following the first laboratory-confirmed case of COVID-19 on 26 January 2020, to minimise in-person contacts that could spread infections. The BC COVID-19 Population Mixing Patterns Survey (BC-Mix) was established as a surveillance system to measure behaviour and contact patterns in BC over time to inform the timing of the easing/re-imposition of control measures. In this paper, we describe the BC-Mix survey design and the demographic characteristics of respondents. PARTICIPANTS The ongoing repeated online survey was launched in September 2020. Participants are mainly recruited through social media platforms (including Instagram, Facebook, YouTube, WhatsApp). A follow-up survey is sent to participants 2-4 weeks after completing the baseline survey. Survey responses are weighted to BC's population by age, sex, geography and ethnicity to obtain generalisable estimates. Additional indices such as the Material and Social Deprivation Index, residential instability, economic dependency, and others are generated using census and location data. FINDINGS TO DATE As of 26 July 2021, over 61 000 baseline survey responses were received of which 41 375 were eligible for analysis. Of the eligible participants, about 60% consented to follow-up and about 27% provided their personal health numbers for linkage with healthcare databases. Approximately 83.5% of respondents were female, 58.7% were 55 years or older, 87.5% identified as white and 45.9% had at least a university degree. After weighting, approximately 50% were female, 39% were 55 years or older, 65% identified as white and 50% had at least a university degree. FUTURE PLANS Multiple papers describing contact patterns, physical distancing measures, regular handwashing and facemask wearing, modelling looking at impact of physical distancing measures and vaccine acceptance, hesitancy and uptake are either in progress or have been published.
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Affiliation(s)
- Prince A Adu
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Mawuena Binka
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Bushra Mahmood
- Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Dahn Jeong
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Makuza Jean Damascene
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Sarafa Iyaniwura
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- Department of Mathematics, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Notice Ringa
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Héctor A Velásquez García
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Stanley Wong
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Amanda Yu
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Sofia Bartlett
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - James Wilton
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Mike A Irvine
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Michael Otterstatter
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Naveed Zafar Janjua
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Health Evaluation & Outcome Sciences, St. Paul's Hospital, Vancouver, British Columbia, Canada
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8
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Briana DD, Papaevangelou V, Malamitsi-Puchner A. Action is needed to tackle the clinical, psychological and socioeconomic impact of perinatal COVID-19. Acta Paediatr 2022; 111:2278-2283. [PMID: 35959999 PMCID: PMC9538449 DOI: 10.1111/apa.16513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/05/2022] [Accepted: 08/11/2022] [Indexed: 11/30/2022]
Abstract
The COVID-19 pandemic has turned perinatal healthcare into a worldwide public health challenge. Although initial data did not demonstrate pregnancy as a more susceptible period to adverse outcomes of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, an increasing number of reports now certify maternal illness as a high-risk condition for the development of maternal-fetal complications. Despite the rarity of SARS-CoV-2 vertical transmission, severe maternal illness might induce adverse perinatal and neonatal outcomes. Additionally, perinatal COVID-19 data may raise concerns about long-term harmful consequences to the offspring in the framework of non-communicable diseases. The World Health Organization, as well as scientific literature, consider the protection of the maternal-fetal dyad against COVID-19 as a critical issue and, therefore, strongly promote and encourage vaccination of pregnant and lactating women. Furthermore, the pandemic has triggered an unprecedented recession, leading to historic levels of unemployment and deprivation, while health, societal, economic and gender inequities particularly affecting low-income and middle-income countries, have increased. This mini-review provides an updated brief report on historical, clinical, psychological and socioeconomic aspects of the COVID-19 pandemic based on 10 lectures presented at the 9th Maria-Delivoria-Papadopoulos Perinatal Symposium, held virtually on 19 March 2022.
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Affiliation(s)
- Despina D Briana
- Third Department of Paediatrics, National and Kapodistrian University of Athens, Medical School, Greece
| | - Vassiliki Papaevangelou
- Third Department of Paediatrics, National and Kapodistrian University of Athens, Medical School, Greece
| | - Ariadne Malamitsi-Puchner
- Third Department of Paediatrics, National and Kapodistrian University of Athens, Medical School, Greece
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9
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Zhan C, Shao L, Zhang X, Yin Z, Gao Y, Tse CK, Yang D, Wu D, Zhang H. Estimating unconfirmed COVID-19 infection cases and multiple waves of pandemic progression with consideration of testing capacity and non-pharmaceutical interventions: A dynamic spreading model. Inf Sci (N Y) 2022; 607:418-439. [PMID: 35693835 PMCID: PMC9169449 DOI: 10.1016/j.ins.2022.05.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 04/16/2022] [Accepted: 05/27/2022] [Indexed: 01/25/2023]
Abstract
The novel coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has unique epidemiological characteristics that include presymptomatic and asymptomatic infections, resulting in a large proportion of infected cases being unconfirmed, including patients with clinical symptoms who have not been identified by screening. These unconfirmed infected individuals move and spread the virus freely, presenting difficult challenges to the control of the pandemic. To reveal the actual pandemic situation in a given region, a simple dynamic susceptible-unconfirmed-confirmed-removed (D-SUCR) model is developed taking into account the influence of unconfirmed cases, the testing capacity, the multiple waves of the pandemic, and the use of non-pharmaceutical interventions. Using this model, the total numbers of infected cases in 51 regions of the USA and 116 countries worldwide are estimated, and the results indicate that only about 40% of the true number of infections have been confirmed. In addition, it is found that if local authorities could enhance their testing capacities and implement a timely strict quarantine strategy after identifying the first infection case, the total number of infected cases could be reduced by more than 90%. Delay in implementing quarantine measures would drastically reduce their effectiveness.
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Affiliation(s)
- Choujun Zhan
- School of Computing, South China Normal University, Guangzhou 510641, China
| | - Lujiao Shao
- Department of Computer Science, Harbin Institute of Technology, Shenzhen 518055, China
| | - Xinyu Zhang
- Department of Computer Science, Harbin Institute of Technology, Shenzhen 518055, China
| | - Ziliang Yin
- Department of Computer Science, Harbin Institute of Technology, Shenzhen 518055, China
| | - Ying Gao
- School of Computer Science and Engineering, South China University of Technology, Guangzhou 510641, China
| | - Chi K. Tse
- Department of Electrical Engineering, City University of Hong Kong, Hong Kong, China
| | - Dong Yang
- Department of Management of Complex Systems, Ernest and Julio Gallo Management Program, School of Engineering, University of California, Merced, CA 95343, USA
| | - Di Wu
- Department of ICT and Natural Science, Norwegian University of Science and Technology, Norway
| | - Haijun Zhang
- Department of Computer Science, Harbin Institute of Technology, Shenzhen 518055, China,Corresponding author
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10
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Barmpounakis P, Demiris N, Kontoyiannis I, Pavlakis GN, Sypsa V. Evaluating the effects of second-dose vaccine-delay policies in European countries: A simulation study based on data from Greece. PLoS One 2022; 17:e0263977. [PMID: 35446847 PMCID: PMC9022792 DOI: 10.1371/journal.pone.0263977] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 02/01/2022] [Indexed: 12/12/2022] Open
Abstract
The results of a simulation-based evaluation of several policies for vaccine rollout are reported, particularly focusing on the effects of delaying the second dose of two-dose vaccines. In the presence of limited vaccine supply, the specific policy choice is a pressing issue for several countries worldwide, and the adopted course of action will affect the extension or easing of non-pharmaceutical interventions in the next months. We employ a suitably generalised, age-structure, stochastic SEIR (Susceptible → Exposed → Infectious → Removed) epidemic model that can accommodate quantitative descriptions of the major effects resulting from distinct vaccination strategies. The different rates of social contacts among distinct age-groups (as well as some other model parameters) are informed by a recent survey conducted in Greece, but the conclusions are much more widely applicable. The results are summarised and evaluated in terms of the total number of deaths and infections as well as life years lost. The optimal strategy is found to be one based on fully vaccinating the elderly/at risk as quickly as possible, while extending the time-interval between the two vaccine doses to 12 weeks for all individuals below 75 years old, in agreement with epidemic theory which suggests targeting a combination of susceptibility and infectivity. This policy, which is similar to the approaches adopted in the UK and in Canada, is found to be effective in reducing deaths and life years lost in the period while vaccination is still being carried out.
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Affiliation(s)
- Petros Barmpounakis
- Department of Statistics, Athens University of Economics and Business, Athens, Greece
- * E-mail:
| | - Nikolaos Demiris
- Department of Statistics, Athens University of Economics and Business, Athens, Greece
| | - Ioannis Kontoyiannis
- Department of Pure Mathematics and Mathematical Statistics, University of Cambridge, Cambridge, United Kingdom
| | - George N. Pavlakis
- Human Retrovirus Section, VB, National Cancer Institute, Frederick, Maryland, United States of America
| | - Vana Sypsa
- Departments of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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11
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Identifying Country-Level Risk Factors for the Spread of COVID-19 in Europe Using Machine Learning. Viruses 2022; 14:v14030625. [PMID: 35337032 PMCID: PMC8955542 DOI: 10.3390/v14030625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/06/2022] [Accepted: 03/14/2022] [Indexed: 01/27/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has resulted in approximately 5 million deaths around the world with unprecedented consequences in people’s daily routines and in the global economy. Despite vast increases in time and money spent on COVID-19-related research, there is still limited information about the factors at the country level that affected COVID-19 transmission and fatality in EU. The paper focuses on the identification of these risk factors using a machine learning (ML) predictive pipeline and an associated explainability analysis. To achieve this, a hybrid dataset was created employing publicly available sources comprising heterogeneous parameters from the majority of EU countries, e.g., mobility measures, policy responses, vaccinations, and demographics/generic country-level parameters. Data pre-processing and data exploration techniques were initially applied to normalize the available data and decrease the feature dimensionality of the data problem considered. Then, a linear ε-Support Vector Machine (ε-SVM) model was employed to implement the regression task of predicting the number of deaths for each one of the three first pandemic waves (with mean square error of 0.027 for wave 1 and less than 0.02 for waves 2 and 3). Post hoc explainability analysis was finally applied to uncover the rationale behind the decision-making mechanisms of the ML pipeline and thus enhance our understanding with respect to the contribution of the selected country-level parameters to the prediction of COVID-19 deaths in EU.
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12
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Andrejko KL, Head JR, Lewnard JA, Remais JV. Longitudinal social contacts among school-aged children during the COVID-19 pandemic: the Bay Area Contacts among Kids (BACK) study. BMC Infect Dis 2022; 22:242. [PMID: 35272626 PMCID: PMC8907906 DOI: 10.1186/s12879-022-07218-4] [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: 08/10/2021] [Accepted: 02/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The San Francisco Bay Area was the first region in the United States to enact school closures to mitigate SARS-CoV-2 transmission. The effects of closures on contact patterns for schoolchildren and their household members remain poorly understood. METHODS We conducted serial cross-sectional surveys (May 2020, September 2020, February 2021) of Bay Area households with children to estimate age-structured daily contact rates for children and their adult household members. We examined changes in contact rates over the course of the COVID-19 pandemic, including after vaccination of household members, and compared contact patterns by household demographics using generalized estimating equations clustered by household. RESULTS We captured contact histories for 1,967 households on behalf of 2,674 children, comprising 15,087 non-household contacts over the three waves of data collection. Shortly after the start of shelter-in-place orders in May 2020, daily contact rates were higher among children from Hispanic families (1.52 more contacts per child per day; [95% CI: 1.14-2.04]), households whose parents were unable to work from home (1.82; [1.40-2.40]), and households with income < $150,000 (1.75; [1.33-2.33]), after adjusting for other demographic characteristics and household clustering. Between May and August 2020, non-household contacts of children increased by 145% (ages 5-12) and 172% (ages 13-17), despite few children returning to in-person instruction. Non-household contact rates among children were higher-by 1.75 [1.28-2.40] and 1.42 [0.89-2.24] contacts per child per day in 5-12 and 13-17 age groups, respectively, in households where at least one adult was vaccinated against COVID-19, compared to children's contact rates in unvaccinated households. CONCLUSIONS Child contact rates rebounded despite schools remaining closed, as parents obtained childcare, children engaged in contact in non-school settings, and family members were vaccinated. The waning reductions observed in non-household contact rates of schoolchildren and their family members during a prolonged school closure suggests the strategy may be ineffective for long-term SARS-CoV-2 transmission mitigation. Reductions in age-assortative contacts were not as apparent amongst children from lower income households or households where adults could not work from home. Heterogeneous reductions in contact patterns raise concerning racial, ethnic and income-based inequities associated with long-term school closures as a COVID-19 mitigation strategy.
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Affiliation(s)
- Kristin L Andrejko
- Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA
| | - Jennifer R Head
- Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA
| | - Joseph A Lewnard
- Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA.,Division of Infectious Diseases & Vaccinology, School of Public Health, University of California, Berkeley, CA, USA.,Center for Computational Biology, College of Engineering, University of California, Berkeley, CA, USA
| | - Justin V Remais
- Division of Environmental Health Sciences, University of California, Berkeley, CA, USA.
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13
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Zhang Y, Wu G, Chen S, Ju X, Yimaer W, Zhang W, Lin S, Hao Y, Gu J, Li J. A review on COVID-19 transmission, epidemiological features, prevention and vaccination. MEDICAL REVIEW 2022; 2:23-49. [PMID: 35658107 PMCID: PMC9047653 DOI: 10.1515/mr-2021-0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 12/13/2021] [Indexed: 11/24/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused hundreds of millions of infections and millions of deaths over past two years. Currently, many countries have still not been able to take the pandemic under control. In this review, we systematically summarized what we have done to mitigate the COVID-19 pandemic, from the perspectives of virus transmission, public health control measures, to the development and vaccination of COVID-19 vaccines. As a virus most likely coming from bats, the SARS-CoV-2 may transmit among people via airborne, faecal-oral, vertical or foodborne routes. Our meta-analysis suggested that the R0 of COVID-19 was 2.9 (95% CI: 2.7–3.1), and the estimates in Africa and Europe could be higher. The median Rt could decrease by 23–96% following the nonpharmacological interventions, including lockdown, isolation, social distance, and face mask, etc. Comprehensive intervention and lockdown were the most effective measures to control the pandemic. According to the pooled R0 in our meta-analysis, there should be at least 93.3% (95% CI: 89.9–96.2%) people being vaccinated around the world. Limited amount of vaccines and the inequity issues in vaccine allocation call for more international cooperation to achieve the anti-epidemic goals and vaccination fairness.
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Affiliation(s)
- Yuqin Zhang
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Gonghua Wu
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Shirui Chen
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Xu Ju
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | | | - Wangjian Zhang
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Shao Lin
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, NY, USA
| | - Yuantao Hao
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
- Sun Yat-Sen University Global Health Institute, School of Public Health and Institute of State Governance, Sun Yat-Sen University, Guangzhou, China
| | - Jing Gu
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Jinghua Li
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
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14
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Mavrovounis G, Mavrovouni D, Mermiri M, Papadaki P, Chalkias A, Zarogiannis S, Christodoulou N, Gourgoulianis K, Pantazopoulos I. Watch Out for Burnout in COVID-19: A Greek Health Care Personnel Study. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580221097829. [PMID: 35604370 PMCID: PMC9130872 DOI: 10.1177/00469580221097829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of the current study was to examine the mental well-being of healthcare personnel (HCP) working in COVID-19 units in Greece and to calculate the prevalence of burnout (BO) amongst them. A questionnaire based on the Maslach Burnout Inventory for Medical Personnel was utilized between February 21st, 2021 and March 5th, 2021. A total of 190 HCP responded to the questionnaire, of which 73.7% were nurses and midwives. The mean age of the participants was 38.3 (8.4) years. Overall, 71.6% of the participants had a high BO score, while 20.5% had a moderate and 7.9% had a low BO score. Night shifts in COVID-19 wards and job dissatisfaction were significantly associated with a high BO score ( P = .03 and P < .0001, respectively). The majority of HCP working in COVID-19 wards in Greece is experiencing high levels of overall BO and emotional exhaustion.
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Affiliation(s)
- Georgios Mavrovounis
- Department of Emergency Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Debbie Mavrovouni
- Department of Psychiatry, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Maria Mermiri
- Department of Anesthesiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | | | - Athanasios Chalkias
- Department of Anesthesiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Sotirios Zarogiannis
- Department of Physiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | | | | | - Ioannis Pantazopoulos
- Department of Emergency Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece
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15
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Bistaraki A, Roussos S, Tsiodras S, Sypsa V. Age-dependent effects on infectivity and susceptibility to SARS-CoV-2 infection: results from nationwide contact tracing data in Greece. Infect Dis (Lond) 2021; 54:186-195. [PMID: 34743646 DOI: 10.1080/23744235.2021.1995627] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Understanding the factors that affect the transmissibility of SARS-CoV-2 remains important to keep transmission low and maximize the health benefits of vaccination. We assessed the factors associated with the transmissibility of SARS-CoV-2 based on contact tracing data. METHODS From 1 October to 9 December 2020, 29,385 laboratory-confirmed SARS-CoV-2 cases (index cases, i.e. the first identified laboratory-confirmed cases or with the earliest symptom onset in a setting) and 64,608 traced contacts were identified in Greece. We assessed the prevalence of symptoms in cases, calculated secondary attack rates and assessed factors associated with infectivity and susceptibility to infection. RESULTS There were 11,232 contacts secondarily infected (secondary attack rate: 17.4%, 95% CI:17.0-17.8). Contacts aged 0-11 and 12-17 years were less susceptible to infection than adults 65 years or older (odds ratio (OR) [95% CI]: 0.28 [0.26-0.32] and 0.44 [0.40-0.49], respectively). Index cases aged 65 years or older were more likely to infect their contacts than other adults or children/adolescents. The odds of infection [95% CI] were higher in contacts exposed within the household (1.71 [1.59-1.85] vs. other) and in cases with cough (1.17 [1.11-1.25] vs. no cough). There was an interaction between the age of the index and the age of the contact with contacts 65 years or older having a higher probability of infection when exposed to cases of similar age than to children. CONCLUSIONS Our findings highlight the role of age and age mixing in infectivity and susceptibility to SARS-CoV-2 infection. Precautions are necessary for individuals 65 or older as they have higher infectivity and susceptibility in contact with their peers.
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Affiliation(s)
- Angeliki Bistaraki
- Department of Nursing, School of Health Sciences, Hellenic Mediterranean University, Crete, Greece
| | - Sotirios Roussos
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Sotirios Tsiodras
- 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vana Sypsa
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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16
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Liu CY, Berlin J, Kiti MC, Del Fava E, Grow A, Zagheni E, Melegaro A, Jenness SM, Omer SB, Lopman B, Nelson K. Rapid Review of Social Contact Patterns During the COVID-19 Pandemic. Epidemiology 2021; 32:781-791. [PMID: 34392254 PMCID: PMC8478104 DOI: 10.1097/ede.0000000000001412] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 08/02/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Physical distancing measures aim to reduce person-to-person contact, a key driver of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. In response to unprecedented restrictions on human contact during the coronavirus disease 2019 (COVID-19) pandemic, studies measured social contact patterns under the implementation of physical distancing measures. This rapid review synthesizes empirical data on the changing social contact patterns during the COVID-19 pandemic. METHOD We conducted a systematic review using PubMed, Medline, Embase, and Google Scholar following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We descriptively compared the distribution of contacts observed during the pandemic to pre-COVID data across countries to explore changes in contact patterns during physical distancing measures. RESULTS We identified 12 studies reporting social contact patterns during the COVID-19 pandemic. Eight studies were conducted in European countries and eleven collected data during the initial mitigation period in the spring of 2020 marked by government-declared lockdowns. Some studies collected additional data after relaxation of initial mitigation. Most study settings reported a mean of between 2 and 5 contacts per person per day, a substantial reduction compared to pre-COVID rates, which ranged from 7 to 26 contacts per day. This reduction was pronounced for contacts outside of the home. Consequently, levels of assortative mixing by age substantially declined. After relaxation of initial mitigation, mean contact rates increased but did not return to pre-COVID levels. Increases in contacts post-relaxation were driven by working-age adults. CONCLUSION Information on changes in contact patterns during physical distancing measures can guide more realistic representations of contact patterns in mathematical models for SARS-CoV-2 transmission.
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Affiliation(s)
- Carol Y. Liu
- From the Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA
| | - Juliette Berlin
- From the Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA
| | - Moses C. Kiti
- From the Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA
| | - Emanuele Del Fava
- Laboratory of Digital and Computational Demography, Max Planck Institute for Demographic Research, Rostock, Germany
| | - André Grow
- Laboratory of Digital and Computational Demography, Max Planck Institute for Demographic Research, Rostock, Germany
| | - Emilio Zagheni
- Laboratory of Digital and Computational Demography, Max Planck Institute for Demographic Research, Rostock, Germany
| | - Alessia Melegaro
- Department of Social and Political Sciences, Centre for Research on Social Dynamics and Public Policy and Covid Crisis Lab, Bocconi University, Milan, Italy
| | - Samuel M. Jenness
- From the Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA
| | - Saad B. Omer
- Department of Epidemiology of Microbial Diseases, Yale Institute of Global Health, Yale University, CT
| | - Benjamin Lopman
- From the Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA
| | - Kristin Nelson
- From the Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA
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17
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Del Fava E, Cimentada J, Perrotta D, Grow A, Rampazzo F, Gil-Clavel S, Zagheni E. Differential impact of physical distancing strategies on social contacts relevant for the spread of SARS-CoV-2: evidence from a cross-national online survey, March-April 2020. BMJ Open 2021; 11:e050651. [PMID: 34675016 PMCID: PMC8532142 DOI: 10.1136/bmjopen-2021-050651] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES We investigate changes in social contact patterns following the gradual introduction of non-pharmaceutical interventions and their implications for infection transmission in the early phase of the pandemic. DESIGN, SETTING AND PARTICIPANTS We conducted an online survey based on targeted Facebook advertising campaigns across eight countries (Belgium, France, Germany, Italy, the Netherlands, Spain, UK and USA), achieving a sample of 51 233 questionnaires in the period 13 March-12 April 2020. Poststratification weights based on census information were produced to correct for selection bias. OUTCOME MEASURES Participants provided data on social contact numbers, adoption of protective behaviours and perceived level of threat. These data were combined to derive a weekly index of infection transmission, the net reproduction number [Formula: see text] . RESULTS Evidence from the USA and UK showed that the number of daily contacts mainly decreased after governments issued the first physical distancing guidelines. In mid-April, daily social contact numbers had decreased between 61% in Germany and 87% in Italy with respect to pre-COVID-19 levels, mostly due to a contraction in contacts outside the home. Such reductions, which were uniform across age groups, were compatible with an [Formula: see text] equal or smaller than one in all countries, except Germany. This indicates lower levels of infection transmission, especially in a period of gradual increase in the adoption rate of the face mask outside the home. CONCLUSIONS We provided a comparable set of statistics on social contact patterns during the COVID-19 pandemic for eight high-income countries, disaggregated by week and other demographic factors, which could be leveraged by the scientific community for developing more realistic epidemic models of COVID-19.
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Affiliation(s)
- Emanuele Del Fava
- Laboratory of Digital and Computational Demography, Max Planck Institute for Demographic Research, Rostock, Germany
| | - Jorge Cimentada
- Laboratory of Digital and Computational Demography, Max Planck Institute for Demographic Research, Rostock, Germany
| | - Daniela Perrotta
- Laboratory of Digital and Computational Demography, Max Planck Institute for Demographic Research, Rostock, Germany
| | - André Grow
- Laboratory of Digital and Computational Demography, Max Planck Institute for Demographic Research, Rostock, Germany
| | - Francesco Rampazzo
- Saïd Business School, Leverhulme Centre for Demographic Science, and Nuffield College, University of Oxford, Oxford, UK
| | - Sofia Gil-Clavel
- Laboratory of Digital and Computational Demography, Max Planck Institute for Demographic Research, Rostock, Germany
| | - Emilio Zagheni
- Laboratory of Digital and Computational Demography, Max Planck Institute for Demographic Research, Rostock, Germany
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18
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Galanis P, Kaitelidou D, Prezerakos P, Kotsiopoulos I, Siskou O, Konstantakopoulou O, Hadjichristodoulou C, Tsiodras S. Low seropositivity for SARS-CoV-2 antibodies among healthcare workers after the first COVID-19 pandemic wave in Greece. Public Health 2021; 198:223-229. [PMID: 34482100 PMCID: PMC8324404 DOI: 10.1016/j.puhe.2021.07.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 06/19/2021] [Accepted: 07/23/2021] [Indexed: 12/24/2022]
Abstract
Objectives To estimate the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seropositivity among healthcare workers (HCWs) in Greece and to identify high-risk groups in healthcare facilities. Study design The study design used in this study is a nationwide cross-sectional study. Methods Data were collected from 1 June to 9 July 2020. HCWs in the Greek National Health System were offered a free SARS-CoV-2 IgG antibody test, regardless of symptoms. Results Overall, 379 of 57,418 HCWs (0.66%, 95% confidence interval [CI]: 0.59–0.73) were positive for SARS-CoV-2 antibodies. The adjusted overall seroprevalence was 0.43% (95% CI: 0.35–0.51). We found that HCWs in non-reference hospitals for COVID-19 (odds ratio [OR]: 1.81, 95% CI: 1.23–2.64; P = 0.002) and reference hospitals for COVID-19 (OR: 1.66, 95% CI: 1.06–2.58; P = 0.03) were more likely to be seropositive than HCWs in primary care centres. Regarding professions, nurses (OR: 1.45, 95% CI: 1.07–1.98; P = 0.02), physicians (OR: 1.43, 95% CI: 1.06–1.93; P = 0.02), and administrative, cleaning and security staff (OR: 1.50, 95% CI: 1.09–2.06; P = 0.01) had a statistically higher chance of having a positive serology than laboratory employees. Conclusions The adjusted overall seroprevalence found in this study indicates a very low prevalence of SARS-CoV-2 among HCWs in Greece. This result is in line with the low incidence of COVID-19 during the first wave of the pandemic and is a direct benefit from the early implementation of lockdown.
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Affiliation(s)
- P Galanis
- Faculty of Nursing, Center for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece.
| | - D Kaitelidou
- Faculty of Nursing, Center for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece.
| | - P Prezerakos
- Department of Nursing, University of Peloponnese, Laboratory of Integrated Health Care, Tripoli, Greece.
| | - I Kotsiopoulos
- General for Health Services, Ministry of Health, Athens, Greece.
| | - O Siskou
- Faculty of Nursing, Center for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece.
| | - O Konstantakopoulou
- Faculty of Nursing, Center for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece.
| | - C Hadjichristodoulou
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece.
| | - S Tsiodras
- Faculty of Medicine, 4th Department of Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece.
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19
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Kostaki EG, Pavlopoulos GA, Verrou KM, Ampatziadis-Michailidis G, Harokopos V, Hatzis P, Moulos P, Siafakas N, Pournaras S, Hadjichristodoulou C, Chatzopoulou F, Chatzidimitriou D, Panagopoulos P, Lourida P, Argyraki A, Lytras T, Sapounas S, Gerolymatos G, Panagiotakopoulos G, Prezerakos P, Tsiodras S, Sypsa V, Hatzakis A, Anastassopoulou C, Spanakis N, Tsakris A, Dimopoulos MA, Kotanidou A, Sfikakis P, Kollias G, Magiorkinis G, Paraskevis D. Molecular Epidemiology of SARS-CoV-2 in Greece Reveals Low Rates of Onward Virus Transmission after Lifting of Travel Restrictions Based on Risk Assessment during Summer 2020. mSphere 2021; 6:e0018021. [PMID: 34190583 PMCID: PMC8265632 DOI: 10.1128/msphere.00180-21] [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: 02/25/2021] [Accepted: 06/06/2021] [Indexed: 12/16/2022] Open
Abstract
The novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread rapidly during the first months of 2020 and continues to expand in multiple areas across the globe. Molecular epidemiology has provided an added value to traditional public health tools by identifying SARS-CoV-2 clusters or providing evidence that clusters based on virus sequences and contact tracing are highly concordant. Our aim was to infer the levels of virus importation and to estimate the impact of public health measures related to travel restrictions to local transmission in Greece. Our phylogenetic and phylogeographic analyses included 389 full-genome SARS-CoV-2 sequences collected during the first 7 months of the pandemic in Greece and a random collection in five replicates of 3,000 sequences sampled globally, as well as the best hits to our data set identified by BLAST. Phylogenetic trees were reconstructed by the maximum likelihood method, and the putative source of SARS-CoV-2 infections was inferred by phylogeographic analysis. Phylogenetic analyses revealed the presence of 89 genetically distinct viruses identified as independent introductions into Greece. The proportion of imported strains was 41%, 11.5%, and 8.8% during the three periods of sampling, namely, March (no travel restrictions), April to June (strict travel restrictions), and July to September (lifting of travel restrictions based on thorough risk assessment), respectively. The results of phylogeographic analysis were confirmed by a Bayesian approach. Our findings reveal low levels of onward transmission from imported cases during summer and underscore the importance of targeted public health measures that can increase the safety of international travel during a pandemic. IMPORTANCE Our study based on current state-of-the-art molecular epidemiology methods suggests that virus screening and public health measures after the lifting of travel restrictions prevented SARS-CoV-2 onward transmission from imported cases during summer 2020 in Greece. These findings provide important data on the efficacy of targeted public health measures and have important implications regarding the safety of international travel during a pandemic. Our results can provide a roadmap about prevention policy in the future regarding the reopening of borders in the presence of differences in vaccination coverage, the circulation of the virus, and the presence of newly emergent variants across the globe.
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Affiliation(s)
- Evangelia Georgia Kostaki
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios A. Pavlopoulos
- Center of New Biotechnologies & Precision Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Institute for Fundamental Biomedical Research, Biomedical Sciences Research Center “Alexander Fleming,” Vari, Greece
| | - Kleio-Maria Verrou
- Center of New Biotechnologies & Precision Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Giannis Ampatziadis-Michailidis
- Center of New Biotechnologies & Precision Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vaggelis Harokopos
- Institute for Fundamental Biomedical Research, Biomedical Sciences Research Center “Alexander Fleming,” Vari, Greece
| | - Pantelis Hatzis
- Center of New Biotechnologies & Precision Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Institute for Fundamental Biomedical Research, Biomedical Sciences Research Center “Alexander Fleming,” Vari, Greece
| | - Panagiotis Moulos
- Center of New Biotechnologies & Precision Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Institute for Fundamental Biomedical Research, Biomedical Sciences Research Center “Alexander Fleming,” Vari, Greece
| | - Nikolaos Siafakas
- Laboratory of Clinical Microbiology, ATTIKON University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Spyridon Pournaras
- Laboratory of Clinical Microbiology, ATTIKON University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Dimitrios Chatzidimitriou
- Labnet, Laboratories, Thessaloniki, Greece
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Periklis Panagopoulos
- 2nd Department of Internal Medicine, General Hospital of Alexandroupoli, Democritus University of Thrace, Alexandroupoli, Greece
| | - Panagiota Lourida
- Infectious Diseases Clinic A, Thoracic Diseases General Hospital Sotiria, Athens, Greece
| | - Aikaterini Argyraki
- Infectious Diseases Clinic A, Thoracic Diseases General Hospital Sotiria, Athens, Greece
| | | | | | | | | | | | - Sotirios Tsiodras
- 4th Department of Internal Medicine, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vana Sypsa
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Angelos Hatzakis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Cleo Anastassopoulou
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Spanakis
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Tsakris
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Meletios Athanasios Dimopoulos
- Center of New Biotechnologies & Precision Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Department of Therapeutics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasia Kotanidou
- 1st Intensive Care Unit, General Hospital Evangelismos, National and Kapodistrian University of Athens, Athens, Greece
| | - Petros Sfikakis
- Center of New Biotechnologies & Precision Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- 1st Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Kollias
- Center of New Biotechnologies & Precision Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Institute for Bioinnovation, Biomedical Sciences Research Center “Alexander Fleming,” Vari, Greece
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Gkikas Magiorkinis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Paraskevis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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20
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Rachaniotis NP, Dasaklis TK, Fotopoulos F, Tinios P. A Two-Phase Stochastic Dynamic Model for COVID-19 Mid-Term Policy Recommendations in Greece: A Pathway towards Mass Vaccination. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2497. [PMID: 33802501 PMCID: PMC7967634 DOI: 10.3390/ijerph18052497] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/24/2021] [Accepted: 02/26/2021] [Indexed: 12/23/2022]
Abstract
From 7 November 2020, Greece adopted a second nationwide lockdown policy to mitigate the transmission of SARS-CoV-2 (the first took place from 23 March to 4 May 2020), just as the second wave of COVID-19 was advancing, as did other European countries. To secure the full benefits of mass vaccination, which started in early January 2021, it is of utmost importance to complement it with mid-term non-pharmaceutical interventions (NPIs). The objective was to minimize human losses and to limit social and economic costs. In this paper a two-phase stochastic dynamic network compartmental model (a pre-vaccination SEIR until 15 February 2021 and a post-vaccination SVEIR from 15 February 2021 to 30 June 2021) is developed. Three scenarios are assessed for the first phase: (a) A baseline scenario, which lifts the national lockdown and all NPIs in January 2021; (b) a "semi-lockdown" scenario with school opening, partial retail sector operation, universal mask wearing, and social distancing/teleworking in January 2021; and (c) a "rolling lockdown" scenario combining a partial lifting of measures in January 2021 followed by a third nationwide lockdown in February 2021. In the second phase three scenarios with different vaccination rates are assessed. Publicly available data along with some first results of the SHARE COVID-19 survey conducted in Greece are used as input. The results regarding the first phase indicate that the "semi-lockdown" scenario clearly outperforms the third lockdown scenario (5.7% less expected fatalities); the second phase is extremely sensitive on the availability of sufficient vaccine supplies and high vaccination rates.
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Affiliation(s)
- Nikolaos P. Rachaniotis
- Department of Industrial Management and Technology, University of Piraeus, 18534 Piraeus, Greece;
| | - Thomas K. Dasaklis
- Department of Industrial Management and Technology, University of Piraeus, 18534 Piraeus, Greece;
| | | | - Platon Tinios
- Department of Statistics and Insurance Science, University of Piraeus, 18534 Piraeus, Greece;
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