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Scholfield S, Kavembe GD, Duncan RR, Ragama BO, Mecha J, Orwa A, Otomu G, Wanga E, Astleford J, Gutto J, Kibwage I, Ogato J, Verma A, Brennan K, Huck J, Mitlin D, Nirmalan M. A cross-sectional survey on the effectiveness of public health campaigns for changing knowledge, attitudes, and practices in Kenyan informal settlements during the COVID-19 pandemic. PLoS One 2023; 18:e0294202. [PMID: 38134188 PMCID: PMC10745220 DOI: 10.1371/journal.pone.0294202] [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: 05/09/2023] [Accepted: 10/26/2023] [Indexed: 12/24/2023] Open
Abstract
We performed two cross-sectional surveys across three informal settlements in Kenya (within Kisii county, Nairobi, and Nakuru county) to study the effectiveness of public health interventions during the COVID-19 pandemic. A total of 720 participants were surveyed from 120 randomly selected geographical locations (240 participants/settlement/survey), and a coordinated health promotion campaign was delivered between the two surveys by trained staff. Information relating to knowledge, attitudes, and practices (KAP) were collected by trained field workers using a validated questionnaire. The main outcomes showed improvements in: (i) mask-wearing (% of participants 'Always' using their mask increased from 71 to 74%, and the percentage using their masks 'Sometimes' decreased from 15% to 6%; p<0.001); (ii) practices related to face mask usage (% of subjects covering the mouth and nose increased from 91 to 95%, and those covering only part of their face decreased from around 2.5% to <1%; p<0.001). Significant improvements were also seen in the attitudes and expectations relating to mask wearing, and in the understanding of government directives. Over 50% of subjects in the post-campaign survey reported that social distancing was not possible in their communities and fears associated with COVID-19 testing were resistant to change (unchanged at 10%). Access to COVID-19 testing facilities was limited, leaving a large proportion of people unable to test. As willingness to take a COVID-19 test did not change between surveys (69 vs 70%; p = 0.57), despite increased availability, we recommend that policy level interventions are needed, aimed at mitigating adverse consequences of a positive test. Improvements of KAPs in the more crowded urban environment (Nairobi) were less than at settlements in rural or semi-urban settings (Nakuru and Kisii). We conclude that coordinated public health campaigns are effective in facilitating the change of KAPs amongst people living amidst challenging socio-economic conditions in informal settlements.
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Affiliation(s)
- Steven Scholfield
- Faculty of Biology, Medicine and Health University of Manchester, Manchester, United Kingdom
| | | | - Rodney R. Duncan
- Department of Monitoring and Evaluation, Central Kenya Conference of SDA, Nairobi, Kenya
| | - Bernhards O. Ragama
- Centre for Research and Therapeutic Sciences, Strathmore University and Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Jared Mecha
- Department of Clinical Medicine and Therapeutics, University of Nairobi, Nairobi, Kenya
| | - Albert Orwa
- Department of Clinical Medicine and Therapeutics, University of Nairobi, Nairobi, Kenya
| | - Geoffrey Otomu
- Department of Medicine, Kisii Teaching and Referral Hospital, Kisii, Kenya
| | - Erick Wanga
- Adventist Development and Relief Agency (ADRA), Nairobi, Kenya
| | - James Astleford
- Adventist Development and Relief Agency (ADRA), Nairobi, Kenya
| | - John Gutto
- Faculty of Biology, Medicine and Health University of Manchester, Manchester, United Kingdom
| | | | - Julius Ogato
- Division of Health Systems Strengthening, Ministry of Health, Nairobi, Kenya
| | - Arpana Verma
- Division of Population Sciences, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Keith Brennan
- Faculty of Biology, Medicine and Health University of Manchester, Manchester, United Kingdom
| | - Jonathan Huck
- MCGIS, Department of Geography, Faculty of Humanities, University of Manchester, Manchester, United Kingdom
| | - Diana Mitlin
- Global Development Institute, Faculty of Humanities, University of Manchester, Manchester, United Kingdom
| | - Mahesh Nirmalan
- Faculty of Biology, Medicine and Health University of Manchester, Manchester, United Kingdom
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Xiong W, Cowling BJ, Tsang TK. Influenza Resurgence after Relaxation of Public Health and Social Measures, Hong Kong, 2023. Emerg Infect Dis 2023; 29:2556-2559. [PMID: 37885047 PMCID: PMC10683823 DOI: 10.3201/eid2912.230937] [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] [Indexed: 10/28/2023] Open
Abstract
Soon after a mask mandate was relaxed (March 1, 2023), the first post-COVID-19 influenza season in Hong Kong lasted 12 weeks. After other preventive measures were accounted for, mask wearing was associated with an estimated 25% reduction in influenza transmission. Influenza resurgence probably resulted from relaxation of mask mandates and other measures.
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Lee HJ, Mun SK, Chang M. Impact of COVID-19 Pandemic on the Incidence of Pediatric Acute Otitis Media in Seoul, South Korea. Otol Neurotol 2023; 44:912-917. [PMID: 37590882 DOI: 10.1097/mao.0000000000003996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
OBJECTIVE The implementation of nonpharmaceutical interventions (NPIs) for coronavirus disease 2019 (COVID-19) may affect the incidence of infectious diseases. This study aimed to evaluate the changes in the incidence of pediatric acute otitis media (AOM) after the COVID-19 outbreak in Seoul, South Korea. STUDY DESIGN Retrospective cohort. SETTING Tertiary referral center. PATIENTS We ascertained the daily number of COVID-19 and pediatric AOM patients between January 20, 2020, and June 19, 2020. During the same period, the number of children using public transportation was used as an index for implementing NPIs. The same period 1 year ago was set as the control period. INTERVENTION Diagnostic. MAIN OUTCOME MEASURE The differences in the incidence of AOM and implementation of NPIs between the COVID-19 pandemic and control period were analyzed using segmented regression analyses. Negative values of difference meant that the number in the COVID-19 pandemic period declined compared with the control period. RESULTS The study period was divided into two sections based on the change point of the COVID-19 cases. In the first period, the increased number of COVID-19 cases decreased, and in the second period, the number of COVID-19 cases increased again. Similar trends were observed in the incidence of AOM and NPI implementation. Before the change point, the study found a significant decreasing trend in the differences in pediatric AOM cases and children using public transportation. However, these trends changed after the change point, with a significant increase in both indices. CONCLUSION Our findings indicate that NPIs for COVID-19 may influence the incidence of pediatric AOM.
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Affiliation(s)
- Hyun-Jin Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong
| | - Seog-Kyun Mun
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Chung-Ang University Hospital, Seoul, South Korea
| | - Munyoung Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Chung-Ang University Hospital, Seoul, South Korea
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Benito PJ, Gutiérrez Á, Rojo-Tirado MA. The real bacterial filtration efficiency to evaluate the effective protection of facemasks used for the prevention of respiratory diseases. Sci Rep 2023; 13:8997. [PMID: 37277420 DOI: 10.1038/s41598-023-35071-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 05/12/2023] [Indexed: 06/07/2023] Open
Abstract
The real protection offered by facemasks to control the transmission of respiratory viruses is still undetermined. Most of the manufacturing regulations, as well as scientific studies, have focused on studying the filtration capacity of the fabrics from which they are made, ignoring the air that escapes through the facial misalignments, and which depends on the respiratory frequencies and volumes. The objective of this work was to define a Real Bacterial Filtration Efficiency for each type of facemask, considering the bacterial filtration efficiency of the manufacturers and the air that passes through them. Nine different facemasks were tested on a mannequin with three gas analyzers (measuring inlet, outlet, and leak volumes) inside a polymethylmethacrylate box. In addition, the differential pressure was measured to determine the resistance offered by the facemasks during the inhalation and exhalation processes. Air was introduced with a manual syringe for 180 s simulating inhalations and exhalations at rest, light, moderate and vigorous activities (10, 60, 80 and 120 L/min, respectively). Statistical analysis showed that practically half of the air entering to the system is not filtered by the facemasks in all intensities (p < 0.001, ηp2 = 0.971). They also showed that the hygienic facemasks filter more than 70% of the air, and their filtration does not depend on the simulated intensity, while the rest of the facemasks show an evidently different response, influenced by the amount of air mobilized. Therefore, the Real Bacterial Filtration Efficiency can be calculated as a modulation of the Bacterial Filtration Efficiencies that depends on the type of facemask. The real filtration capacity of the facemasks has been overestimated during last years since the filtration of the fabrics is not the real filtration when the facemask is worn.
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Affiliation(s)
- Pedro J Benito
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sports Science, Universidad Politécnica de Madrid, 28040, Madrid, Spain.
| | - Álvaro Gutiérrez
- ETSI Telecomunicación, Universidad Politécnica de Madrid, Av. Complutense 30, 28040, Madrid, Spain
| | - Miguel A Rojo-Tirado
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sports Science, Universidad Politécnica de Madrid, 28040, Madrid, Spain
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Kisielinski K, Wagner S, Hirsch O, Klosterhalfen B, Prescher A. Possible toxicity of chronic carbon dioxide exposure associated with face mask use, particularly in pregnant women, children and adolescents - A scoping review. Heliyon 2023; 9:e14117. [PMID: 37057051 PMCID: PMC9981272 DOI: 10.1016/j.heliyon.2023.e14117] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 02/14/2023] [Accepted: 02/21/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction During the SARS-CoV-2-pandemic, face masks have become one of the most important ubiquitous factors affecting human breathing. It increases the resistance and dead space volume leading to a re-breathing of CO2. So far, this phenomenon and possible implications on early life has not been evaluated in depth. Method As part of a scoping review, literature was systematically reviewed regarding CO2 exposure and facemask use. Results Fresh air has around 0.04% CO2, while wearing masks more than 5 min bears a possible chronic exposure to carbon dioxide of 1.41% to 3.2% of the inhaled air. Although the buildup is usually within the short-term exposure limits, long-term exceedances and consequences must be considered due to experimental data. US Navy toxicity experts set the exposure limits for submarines carrying a female crew to 0.8% CO2 based on animal studies which indicated an increased risk for stillbirths. Additionally, mammals who were chronically exposed to 0.3% CO2 the experimental data demonstrate a teratogenicity with irreversible neuron damage in the offspring, reduced spatial learning caused by brainstem neuron apoptosis and reduced circulating levels of the insulin-like growth factor-1. With significant impact on three readout parameters (morphological, functional, marker) this chronic 0.3% CO2 exposure has to be defined as being toxic. Additional data exists on the exposure of chronic 0.3% CO2 in adolescent mammals causing neuron destruction, which includes less activity, increased anxiety and impaired learning and memory. There is also data indicating testicular toxicity in adolescents at CO2 inhalation concentrations above 0.5%. Discussion There is a possible negative impact risk by imposing extended mask mandates especially for vulnerable subgroups. Circumstantial evidence exists that extended mask use may be related to current observations of stillbirths and to reduced verbal motor and overall cognitive performance in children born during the pandemic. A need exists to reconsider mask mandates.
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Affiliation(s)
- Kai Kisielinski
- Independent Researcher, Surgeon, Private Practice, 40212 Düsseldorf, Germany
| | - Susanne Wagner
- Non Clinical Expert, Veterinarian, Wagner MSL Management, 15831 Mahlow, Germany
| | - Oliver Hirsch
- Department of Psychology, FOM University of Applied Sciences, 57078 Siegen, Germany
| | | | - Andreas Prescher
- Institute of Molecular and Cellular Anatomy (MOCA), 52074 Aachen, Germany
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Huberts NFD, Thijssen JJJ. Optimal timing of non-pharmaceutical interventions during an epidemic. EUROPEAN JOURNAL OF OPERATIONAL RESEARCH 2023; 305:1366-1389. [PMID: 35765314 PMCID: PMC9221090 DOI: 10.1016/j.ejor.2022.06.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/15/2022] [Indexed: 05/10/2023]
Abstract
In response to the recent outbreak of the SARS-CoV-2 virus governments have aimed to reduce the virus's spread through, inter alia, non-pharmaceutical intervention. We address the question when such measures should be implemented and, once implemented, when to remove them. These issues are viewed through a real-options lens and we develop an SIRD-like continuous-time Markov chain model to analyze a sequence of options: the option to intervene and introduce measures and, after intervention has started, the option to remove these. Measures can be imposed multiple times. We implement our model using estimates from empirical studies and, under fairly general assumptions, our main conclusions are that: (1) measures should be put in place not long after the first infections occur; (2) if the epidemic is discovered when there are many infected individuals already, then it is optimal never to introduce measures; (3) once the decision to introduce measures has been taken, these should stay in place until the number of susceptible or infected members of the population is close to zero; (4) it is never optimal to introduce a tier system to phase-in measures but it is optimal to use a tier system to phase-out measures; (5) a more infectious variant may reduce the duration of measures being in place; (6) the risk of infections being brought in by travelers should be curbed even when no other measures are in place. These results are robust to several variations of our base-case model.
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Affiliation(s)
- Nick F D Huberts
- Management School, University of York, Heslington, York YO10 5ZF, United Kingdom
| | - Jacco J J Thijssen
- Management School, University of York, Heslington, York YO10 5ZF, United Kingdom
- Department of Mathematics, University of York, Heslington, York YO10 5ZF, United Kingdom
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Tandjaoui-Lambiotte Y, Lomont A, Moenne-Locoz P, Seytre D, Zahar JR. Spread of viruses, which measures are the most apt to control COVID-19? Infect Dis Now 2023; 53:104637. [PMID: 36526247 PMCID: PMC9746078 DOI: 10.1016/j.idnow.2022.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 11/22/2022] [Accepted: 12/06/2022] [Indexed: 12/15/2022]
Abstract
The persistent debate about the modes of transmission of SARS-CoV2 and preventive measures has illustrated the limits of our knowledge regarding the measures to be implemented in the face of viral risk. Past and present (pandemic-related) scientific data underline the complexity of the phenomenon and its variability over time. Several factors contribute to the risk of transmission, starting with incidence in the general population (i.e., colonization pressure) and herd immunity. Other major factors include intensity of symptoms, interactions with the reservoir (proximity and duration of contact), the specific characteristics of the virus(es) involved, and a number of unpredictable elements (humidity, temperature, ventilation…). In this review, we will emphasize the difficulty of "standardizing" the situations that might explain the discrepancies found in the literature. We will show that the airborne route remains the main mode of transmission. Regarding preventive measures of prevention, while vaccination remains the cornerstone of the fight against viral outbreaks, we will remind the reader that wearing a mask is the main barrier measure and that the choice of type of mask depends on the risk situations. Finally, we believe that the recent pandemic should induce us in the future to modify our recommendations by adapting our measures in hospitals, not to the pathogen concerned, which is currently the case, but rather to the type of at-risk situation.
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Affiliation(s)
- Y Tandjaoui-Lambiotte
- Service de Pneumologie-Infectiologie, CH Saint Denis, 2 rue Dr. Delafontaine, 93200, France
| | - A Lomont
- Unité de Prévention du Risque Infectieux, Service de microbiologie clinique, GHU Paris Seine Saint-Denis, Université Sorbonne Paris Nord, France
| | - P Moenne-Locoz
- Unité de Prévention du Risque Infectieux, Service de microbiologie clinique, GHU Paris Seine Saint-Denis, Université Sorbonne Paris Nord, France
| | - D Seytre
- Unité de Prévention du Risque Infectieux, Service de microbiologie clinique, GHU Paris Seine Saint-Denis, Université Sorbonne Paris Nord, France
| | - J R Zahar
- Unité de Prévention du Risque Infectieux, Service de microbiologie clinique, GHU Paris Seine Saint-Denis, Université Sorbonne Paris Nord, France.
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Jefferson T, Dooley L, Ferroni E, Al-Ansary LA, van Driel ML, Bawazeer GA, Jones MA, Hoffmann TC, Clark J, Beller EM, Glasziou PP, Conly JM. Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database Syst Rev 2023; 1:CD006207. [PMID: 36715243 PMCID: PMC9885521 DOI: 10.1002/14651858.cd006207.pub6] [Citation(s) in RCA: 33] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Viral epidemics or pandemics of acute respiratory infections (ARIs) pose a global threat. Examples are influenza (H1N1) caused by the H1N1pdm09 virus in 2009, severe acute respiratory syndrome (SARS) in 2003, and coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 in 2019. Antiviral drugs and vaccines may be insufficient to prevent their spread. This is an update of a Cochrane Review last published in 2020. We include results from studies from the current COVID-19 pandemic. OBJECTIVES To assess the effectiveness of physical interventions to interrupt or reduce the spread of acute respiratory viruses. SEARCH METHODS We searched CENTRAL, PubMed, Embase, CINAHL, and two trials registers in October 2022, with backwards and forwards citation analysis on the new studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) and cluster-RCTs investigating physical interventions (screening at entry ports, isolation, quarantine, physical distancing, personal protection, hand hygiene, face masks, glasses, and gargling) to prevent respiratory virus transmission. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methodological procedures. MAIN RESULTS We included 11 new RCTs and cluster-RCTs (610,872 participants) in this update, bringing the total number of RCTs to 78. Six of the new trials were conducted during the COVID-19 pandemic; two from Mexico, and one each from Denmark, Bangladesh, England, and Norway. We identified four ongoing studies, of which one is completed, but unreported, evaluating masks concurrent with the COVID-19 pandemic. Many studies were conducted during non-epidemic influenza periods. Several were conducted during the 2009 H1N1 influenza pandemic, and others in epidemic influenza seasons up to 2016. Therefore, many studies were conducted in the context of lower respiratory viral circulation and transmission compared to COVID-19. The included studies were conducted in heterogeneous settings, ranging from suburban schools to hospital wards in high-income countries; crowded inner city settings in low-income countries; and an immigrant neighbourhood in a high-income country. Adherence with interventions was low in many studies. The risk of bias for the RCTs and cluster-RCTs was mostly high or unclear. Medical/surgical masks compared to no masks We included 12 trials (10 cluster-RCTs) comparing medical/surgical masks versus no masks to prevent the spread of viral respiratory illness (two trials with healthcare workers and 10 in the community). Wearing masks in the community probably makes little or no difference to the outcome of influenza-like illness (ILI)/COVID-19 like illness compared to not wearing masks (risk ratio (RR) 0.95, 95% confidence interval (CI) 0.84 to 1.09; 9 trials, 276,917 participants; moderate-certainty evidence. Wearing masks in the community probably makes little or no difference to the outcome of laboratory-confirmed influenza/SARS-CoV-2 compared to not wearing masks (RR 1.01, 95% CI 0.72 to 1.42; 6 trials, 13,919 participants; moderate-certainty evidence). Harms were rarely measured and poorly reported (very low-certainty evidence). N95/P2 respirators compared to medical/surgical masks We pooled trials comparing N95/P2 respirators with medical/surgical masks (four in healthcare settings and one in a household setting). We are very uncertain on the effects of N95/P2 respirators compared with medical/surgical masks on the outcome of clinical respiratory illness (RR 0.70, 95% CI 0.45 to 1.10; 3 trials, 7779 participants; very low-certainty evidence). N95/P2 respirators compared with medical/surgical masks may be effective for ILI (RR 0.82, 95% CI 0.66 to 1.03; 5 trials, 8407 participants; low-certainty evidence). Evidence is limited by imprecision and heterogeneity for these subjective outcomes. The use of a N95/P2 respirators compared to medical/surgical masks probably makes little or no difference for the objective and more precise outcome of laboratory-confirmed influenza infection (RR 1.10, 95% CI 0.90 to 1.34; 5 trials, 8407 participants; moderate-certainty evidence). Restricting pooling to healthcare workers made no difference to the overall findings. Harms were poorly measured and reported, but discomfort wearing medical/surgical masks or N95/P2 respirators was mentioned in several studies (very low-certainty evidence). One previously reported ongoing RCT has now been published and observed that medical/surgical masks were non-inferior to N95 respirators in a large study of 1009 healthcare workers in four countries providing direct care to COVID-19 patients. Hand hygiene compared to control Nineteen trials compared hand hygiene interventions with controls with sufficient data to include in meta-analyses. Settings included schools, childcare centres and homes. Comparing hand hygiene interventions with controls (i.e. no intervention), there was a 14% relative reduction in the number of people with ARIs in the hand hygiene group (RR 0.86, 95% CI 0.81 to 0.90; 9 trials, 52,105 participants; moderate-certainty evidence), suggesting a probable benefit. In absolute terms this benefit would result in a reduction from 380 events per 1000 people to 327 per 1000 people (95% CI 308 to 342). When considering the more strictly defined outcomes of ILI and laboratory-confirmed influenza, the estimates of effect for ILI (RR 0.94, 95% CI 0.81 to 1.09; 11 trials, 34,503 participants; low-certainty evidence), and laboratory-confirmed influenza (RR 0.91, 95% CI 0.63 to 1.30; 8 trials, 8332 participants; low-certainty evidence), suggest the intervention made little or no difference. We pooled 19 trials (71, 210 participants) for the composite outcome of ARI or ILI or influenza, with each study only contributing once and the most comprehensive outcome reported. Pooled data showed that hand hygiene may be beneficial with an 11% relative reduction of respiratory illness (RR 0.89, 95% CI 0.83 to 0.94; low-certainty evidence), but with high heterogeneity. In absolute terms this benefit would result in a reduction from 200 events per 1000 people to 178 per 1000 people (95% CI 166 to 188). Few trials measured and reported harms (very low-certainty evidence). We found no RCTs on gowns and gloves, face shields, or screening at entry ports. AUTHORS' CONCLUSIONS The high risk of bias in the trials, variation in outcome measurement, and relatively low adherence with the interventions during the studies hampers drawing firm conclusions. There were additional RCTs during the pandemic related to physical interventions but a relative paucity given the importance of the question of masking and its relative effectiveness and the concomitant measures of mask adherence which would be highly relevant to the measurement of effectiveness, especially in the elderly and in young children. There is uncertainty about the effects of face masks. The low to moderate certainty of evidence means our confidence in the effect estimate is limited, and that the true effect may be different from the observed estimate of the effect. The pooled results of RCTs did not show a clear reduction in respiratory viral infection with the use of medical/surgical masks. There were no clear differences between the use of medical/surgical masks compared with N95/P2 respirators in healthcare workers when used in routine care to reduce respiratory viral infection. Hand hygiene is likely to modestly reduce the burden of respiratory illness, and although this effect was also present when ILI and laboratory-confirmed influenza were analysed separately, it was not found to be a significant difference for the latter two outcomes. Harms associated with physical interventions were under-investigated. There is a need for large, well-designed RCTs addressing the effectiveness of many of these interventions in multiple settings and populations, as well as the impact of adherence on effectiveness, especially in those most at risk of ARIs.
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Affiliation(s)
- Tom Jefferson
- Department for Continuing Education, University of Oxford, Oxford OX1 2JA, UK
| | - Liz Dooley
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Eliana Ferroni
- Epidemiological System of the Veneto Region, Regional Center for Epidemiology, Veneto Region, Padova, Italy
| | - Lubna A Al-Ansary
- Department of Family and Community Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mieke L van Driel
- General Practice Clinical Unit, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Ghada A Bawazeer
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Mark A Jones
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Tammy C Hoffmann
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Justin Clark
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Elaine M Beller
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Paul P Glasziou
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - John M Conly
- Cumming School of Medicine, University of Calgary, Room AGW5, SSB, Foothills Medical Centre, Calgary, Canada
- O'Brien Institute for Public Health and Synder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Calgary Zone, Alberta Health Services, Calgary, Canada
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Moy N, Antonini M, Kyhlstedt M, Fiorentini G, Paolucci F. Standardising policy and technology responses in the immediate aftermath of a pandemic: a comparative and conceptual framework. Health Res Policy Syst 2023; 21:10. [PMID: 36698139 PMCID: PMC9875766 DOI: 10.1186/s12961-022-00951-x] [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: 03/11/2022] [Accepted: 12/17/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The initial policy response to the COVID-19 pandemic has differed widely across countries. Such variability in government interventions has made it difficult for policymakers and health research systems to compare what has happened and the effectiveness of interventions across nations. Timely information and analysis are crucial to addressing the lag between the pandemic and government responses to implement targeted interventions to alleviate the impact of the pandemic. METHODS To examine the effect government interventions and technological responses have on epidemiological and economic outcomes, this policy paper proposes a conceptual framework that provides a qualitative taxonomy of government policy directives implemented in the immediate aftermath of a pandemic announcement and before vaccines are implementable. This framework assigns a gradient indicating the intensity and extent of the policy measures and applies the gradient to four countries that share similar institutional features but different COVID-19 experiences: Italy, New Zealand, the United Kingdom and the United States of America. RESULTS Using the categorisation framework allows qualitative information to be presented, and more specifically the gradient can show the dynamic impact of policy interventions on specific outcomes. We have observed that the policy categorisation described here can be used by decision-makers to examine the impacts of major viral outbreaks such as SARS-CoV-2 on health and economic outcomes over time. The framework allows for a visualisation of the frequency and comparison of dominant policies and provides a conceptual tool to assess how dominant interventions (and innovations) affect different sets of health and non-health related outcomes during the response phase to the pandemic. CONCLUSIONS Policymakers and health researchers should converge toward an optimal set of policy interventions to minimize the costs of the pandemic (i.e., health and economic), and facilitate coordination across governance levels before effective vaccines are produced. The proposed framework provides a useful tool to direct health research system resources and build a policy benchmark for future viral outbreaks where vaccines are not readily available.
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Affiliation(s)
- Naomi Moy
- grid.6292.f0000 0004 1757 1758Department of Sociology and Business Law, University of Bologna, Strada Maggiore 45, 40126 Bologna, Italy ,grid.1024.70000000089150953Present Address: Centre for Behavioural Economics, Society and Technology, Queensland University of Technology, 2 George Street, Brisbane, QLD 4000 Australia
| | - Marcello Antonini
- grid.266842.c0000 0000 8831 109XSchool of Medicine and Public Health, University of Newcastle, University Dr , Callaghan, NSW 2308 Australia
| | | | - Gianluca Fiorentini
- grid.6292.f0000 0004 1757 1758Department of Economics, University of Bologna, Piazza Scaravilli 2, 40126 Bologna, Italy
| | - Francesco Paolucci
- grid.6292.f0000 0004 1757 1758Department of Sociology and Business Law, University of Bologna, Strada Maggiore 45, 40126 Bologna, Italy ,grid.266842.c0000 0000 8831 109XNewcastle Business School, University of Newcastle, Hunter St &, Auckland St, Newcastle, NSW 2300 Australia
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10
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Braga PP, Souza MSD, Oliveira PPD, Romano MCC, Rocha GM, Gesteira ECR. Children wearing face masks to prevent communicable diseases: scoping review. REVISTA PAULISTA DE PEDIATRIA 2023; 41:e2021164. [PMID: 35858041 PMCID: PMC9345171 DOI: 10.1590/1984-0462/2023/41/2021164] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 09/19/2021] [Indexed: 11/22/2022]
Abstract
Objective: To identify and synthesize scientific evidence that the use of face protection masks by children, in the community and at home, is a way of preventing communicable diseases. Data source: A scoping review was made using the Joana Briggs Institute method and PRISMA-ScR. A research was carried out in five electronic databases, at the Cochrane Library and on seven websites of governmental and non-governmental institutions. The data were organized in a spreadsheet and submitted to narrative analysis. Data synthesis: Initially, 658 productions were identified, of which 19 made up the final sample. Studies with higher levels of evidence are scarce. The types of masks identified were professional (surgical and facial respirators with filtration) and non-professional (homemade). The transmissible agents studied were influenza and SARS-CoV-2 viruses, and the evaluated environments were schools, homes and community spaces. The main discomforts reported were heat, shortness of breath, headache and maladjustment to the face. The indication and acceptability of masks change according to the age group and clinical conditions. There is no consensus on the reduction in the transmissibility of infections. Conclusions: Children older than five can benefit from the correct use of masks, as long as they are supervised, taught and educated to do so and the masks should be well adjusted to the face. The use of masks show better results when associated with other measures such as physical distancing, keeping places ventilated and frequent hand hygiene.
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11
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Sobierajski T, Rykowska D, Wanke-Rytt M, Kuchar E. Vaccine or Garlic-Is It a Choice? Awareness of Medical Personnel on Prevention of Influenza Infections. Vaccines (Basel) 2022; 11:vaccines11010066. [PMID: 36679911 PMCID: PMC9865668 DOI: 10.3390/vaccines11010066] [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: 11/07/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Preventing the spread of the influenza virus is one of the primary health policy challenges of many countries worldwide. One of the more effective ways to prevent infection is influenza vaccination, and the people who enjoy the most public confidence in preventive health care are health workers (HWs). For this reason, it is crucial to study the attitudes of HWs toward influenza vaccination. METHODS The survey was conducted among 950 medical (physicians and nurses) and administrative staff in three academic hospitals. Respondents to the survey were selected on a random-target basis to represent hospital employees in the study best. The survey was conducted using the PAPI method between August and September 2020. RESULTS Respondents considered hand washing (52.8%) and avoiding contact with sick people (49.3%) the most effective ways to prevent influenza infection. Three in ten respondents considered wearing a protective mask (30.1%) and getting vaccinated against influenza (29.9%) is fully effective in preventing influenza. Influenza vaccination as effective in preventing influenza virus infection was chosen more often by those who worked in a pediatric hospital. Nurses were twice less likely than physicians to declare that influenza vaccination prevents infection (42.4% for nurses vs. 84.0% for physicians). At the same time, 20.4% of nurses believed that eating garlic effectively prevented influenza infection, and 28.1% declared daily vitamin C helpful. CONCLUSIONS The study pointed to significant educational gaps regarding the role and effectiveness of influenza vaccination in the process of influenza virus infection and indicated a firm belief in medical myths, especially in the nursing community, related to protection against influenza virus infection.
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Affiliation(s)
- Tomasz Sobierajski
- Faculty of Applied Social Sciences and Resocialization, University of Warsaw, 26/28 Krakowskie Przedmieście Str., 00-927 Warsaw, Poland
- Correspondence: ; Tel.: +48-503-456-234
| | - Dominika Rykowska
- Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, 63a Żwirki & Wigury Str., 02-091 Warsaw, Poland
| | - Monika Wanke-Rytt
- Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, 63a Żwirki & Wigury Str., 02-091 Warsaw, Poland
| | - Ernest Kuchar
- Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, 63a Żwirki & Wigury Str., 02-091 Warsaw, Poland
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Zhang B, Huang W, Pei S, Zeng J, Shen W, Wang D, Wang G, Chen T, Yang L, Cheng P, Wang D, Shu Y, Du X. Mechanisms for the circulation of influenza A(H3N2) in China: A spatiotemporal modelling study. PLoS Pathog 2022; 18:e1011046. [PMID: 36525468 PMCID: PMC9803318 DOI: 10.1371/journal.ppat.1011046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 12/30/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
Circulation of seasonal influenza is the product of complex interplay among multiple drivers, yet characterizing the underlying mechanism remains challenging. Leveraging the diverse seasonality of A(H3N2) virus and abundant climatic space across regions in China, we quantitatively investigated the relative importance of population susceptibility, climatic factors, and antigenic change on the dynamics of influenza A(H3N2) through an integrative modelling framework. Specifically, an absolute humidity driven multiscale transmission model was constructed for the 2013/2014, 2014/2015 and 2016/2017 influenza seasons that were dominated by influenza A(H3N2). We revealed the variable impact of absolute humidity on influenza transmission and differences in the occurring timing and magnitude of antigenic change for those three seasons. Overall, the initial population susceptibility, climatic factors, and antigenic change explained nearly 55% of variations in the dynamics of influenza A(H3N2). Specifically, the additional variation explained by the initial population susceptibility, climatic factors, and antigenic change were at 33%, 26%, and 48%, respectively. The vaccination program alone failed to fully eliminate the summer epidemics of influenza A(H3N2) and non-pharmacological interventions were needed to suppress the summer circulation. The quantitative understanding of the interplay among driving factors on the circulation of influenza A(H3N2) highlights the importance of simultaneous monitoring of fluctuations for related factors, which is crucial for precise and targeted prevention and control of seasonal influenza.
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Affiliation(s)
- Bing Zhang
- School of Public Health (Shenzhen), Sun Yat-sen University, Guangzhou, People’s Republic of China
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, People’s Republic of China
- Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, People’s Republic of China
| | - Weijuan Huang
- National Institute for Viral Disease Control and Prevention, Collaboration Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Sen Pei
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, United States of America
| | - Jinfeng Zeng
- School of Public Health (Shenzhen), Sun Yat-sen University, Guangzhou, People’s Republic of China
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, People’s Republic of China
| | - Wei Shen
- School of Public Health (Shenzhen), Sun Yat-sen University, Guangzhou, People’s Republic of China
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, People’s Republic of China
- Department of Rheumatology and Immunology, Drum Tower Clinic Medical College of Nanjing Medical University, Nanjing, People’s Republic of China
| | - Daoze Wang
- School of Public Health (Shenzhen), Sun Yat-sen University, Guangzhou, People’s Republic of China
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, People’s Republic of China
| | - Gang Wang
- School of Public Health (Shenzhen), Sun Yat-sen University, Guangzhou, People’s Republic of China
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, People’s Republic of China
| | - Tao Chen
- National Institute for Viral Disease Control and Prevention, Collaboration Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Lei Yang
- National Institute for Viral Disease Control and Prevention, Collaboration Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Peiwen Cheng
- School of Public Health (Shenzhen), Sun Yat-sen University, Guangzhou, People’s Republic of China
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, People’s Republic of China
| | - Dayan Wang
- National Institute for Viral Disease Control and Prevention, Collaboration Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
- * E-mail: (DW); (YS); (XD)
| | - Yuelong Shu
- School of Public Health (Shenzhen), Sun Yat-sen University, Guangzhou, People’s Republic of China
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, People’s Republic of China
- Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, People’s Republic of China
- Institute of Pathogen Biology of Chinese Academy of Medical Science (CAMS)/ Peking Union Medical College (PUMC), Beijing, People’s Republic of China
- * E-mail: (DW); (YS); (XD)
| | - Xiangjun Du
- School of Public Health (Shenzhen), Sun Yat-sen University, Guangzhou, People’s Republic of China
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, People’s Republic of China
- Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, People’s Republic of China
- * E-mail: (DW); (YS); (XD)
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Bajiya VP, Bugalia S, Tripathi JP, Martcheva M. Deciphering the transmission dynamics of COVID-19 in India: optimal control and cost effective analysis. JOURNAL OF BIOLOGICAL DYNAMICS 2022; 16:665-712. [PMID: 36099305 DOI: 10.1080/17513758.2022.2116493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 08/09/2022] [Indexed: 06/15/2023]
Abstract
In this paper we assess the effectiveness of different non-pharmaceutical interventions (NPIs) against COVID-19 utilizing a compartmental model. The local asymptotic stability of equilibria (disease-free and endemic) in terms of the basic reproduction number have been determined. We find that the system undergoes a backward bifurcation in the case of imperfect quarantine. The parameters of the model have been estimated from the total confirmed cases of COVID-19 in India. Sensitivity analysis of the basic reproduction number has been performed. The findings also suggest that effectiveness of face masks plays a significant role in reducing the COVID-19 prevalence in India. Optimal control problem with several control strategies has been investigated. We find that the intervention strategies including implementation of lockdown, social distancing, and awareness only, has the highest cost-effectiveness in controlling the infection. This combined strategy also has the least value of average cost-effectiveness ratio (ACER) and associated cost.
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Affiliation(s)
- Vijay Pal Bajiya
- Department of Mathematics, Central University of Rajasthan, Ajmer, Rajasthan, India
| | - Sarita Bugalia
- Department of Mathematics, Central University of Rajasthan, Ajmer, Rajasthan, India
| | - Jai Prakash Tripathi
- Department of Mathematics, Central University of Rajasthan, Ajmer, Rajasthan, India
| | - Maia Martcheva
- Department of Mathematics, University of Florida, Gainesville, FL, USA
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Face masks to prevent transmission of respiratory infections: Systematic review and meta-analysis of randomized controlled trials on face mask use. PLoS One 2022; 17:e0271517. [PMID: 36454947 PMCID: PMC9714953 DOI: 10.1371/journal.pone.0271517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 07/04/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES To examine the use of face mask intervention in mitigating the risk of spreading respiratory infections and whether the effect of face mask intervention differs in different exposure settings and age groups. DESIGN Systematic review and meta-analysis. We evaluated the risk of bias using the Cochrane Risk of Bias 2 tool (ROB2). DATA SOURCES We searched PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science were searched for randomized controlled trials investigating the effect of face masks on respiratory infections published between 1981 and February 9, 2022. We followed the PRISMA 2020 guidelines. ELIGIBILITY CRITERIA FOR SELECTING STUDIES We included randomized controlled trials investigating the use of face mask intervention in mitigating the risk of spreading respiratory infections across different exposure settings. RESULTS We identified 2,400 articles for screening. 18 articles passed the inclusion criteria for both evidence synthesis and meta-analysis. There were N = 189,145 individuals in the face mask intervention arm and N = 173,536 in the control arm, and the follow-up times ranged from 4 days to 19 months. Our results showed between-study heterogeneity (p < 0.0001). While there was no statistically significant association over all studies when the covariate unadjusted intervention effect estimates were used (RR = 0.977 [0.858-1.113], p = 0.728), our subgroup analyses revealed that a face mask intervention reduced respiratory infections in the adult subgroup (RR = 0.8795 [0.7861-0.9839], p = 0.0249) and in a community setting (RR = 0.890 [0.812-0.975], p = 0.0125). Furthermore, our leave-one-out analysis found that one study biased the results towards a null effect. Consequently, when using covariate adjusted odds ratio estimates to have a more precise effect estimates of the intervention effect to account for differences at the baseline, the results showed that a face mask intervention did reduce respiratory infections when the biasing study was excluded from the analysis (OR = 0.8892 [0.8061-0.9810], p = 0.0192). CONCLUSION Our findings support the use of face masks particularly in a community setting and for adults. We also observed substantial between-study heterogeneity and varying adherence to protocol. Notably, many studies were subject to contamination bias thus affecting the efficacy of the intervention, that is when also some controls used masks or when the intervention group did not comply with mask use leading to a downward biased effect of treatment receipt and efficacy. TRIAL REGISTRATION PROSPERO registration number CRD42020205523.
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15
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Shobako N. Lessons from the health policies for children during the pandemic in Japan. Front Public Health 2022; 10:1015955. [PMID: 36339184 PMCID: PMC9628751 DOI: 10.3389/fpubh.2022.1015955] [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: 08/10/2022] [Accepted: 09/21/2022] [Indexed: 01/28/2023] Open
Abstract
It is everyone's desire to seek the sound growth of children through food education and there is a critical need for fostering an environment for this purpose. Health policies are important for this support. To the present, the Japanese society has been greatly disrupted by COVID-19 pandemic. "Stay at home", "mokusyoku (silent eating)", and mask wearing were encouraged in nationwide campaigns as public health measures to combat COVID-19. There are some papers reporting negative effects of "stay at home" and lockdowns such as weight gain, decrease in physical activities and change in eating habits. In Japan, while benefits and advantages of food education during mealtime were previously well studied, the "mokusyoku" rule may directly run counter to this food education. Moreover, there are several reports showing that nutrients might contribute to prevention of infectious diseases. Japanese children were also encouraged to wear masks all day long. The results of the clinical research, especially randomized control trials, show limited protective effect of masks. On the other hand, negative outcomes of the masks were reported in various scenes. This review focuses on these topics and arousing reconsideration for a better environment for children.
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16
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Indirect Protection from Vaccinating Children against Influenza A Virus Infection in Households. Viruses 2022; 14:v14102097. [PMID: 36298653 PMCID: PMC9610389 DOI: 10.3390/v14102097] [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: 09/05/2022] [Revised: 09/18/2022] [Accepted: 09/19/2022] [Indexed: 11/17/2022] Open
Abstract
Influenza vaccination is an important intervention to prevent influenza virus infection. Our previous analysis suggested that indirect protection is limited in an influenza B epidemic in Hong Kong. We further analyzed six influenza A epidemics to determine such potential. We applied a statistical model to estimate household transmission dynamics in the 3 influenza A(H3N2) and 3 pandemic influenza A(H1N1) epidemics. Then, we estimated the reduction in infection risk among unvaccinated household members when all children in households are vaccinated, with different assumptions on vaccine efficacy (VE). In the optimal scenario that VE was 70%, the reduction to the total probability of infection was only marginal, with relative probabilities ranged from 0.91–0.94 when all children in households were vaccinated because community was by far the main source of infection during the six epidemics in our study. The proportion of cases attributed to household transmission was 10% (95% CrI: 7%, 13%). Individual influenza vaccination is important even when other household members are vaccinated, given the degree of indirect protection is small.
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17
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Nasiri MJ, Danaei B, Deravi N, Chirani AS, Bonjar AHS, Khoshgoftar Z, Karimi F. Impact of educational interventions on the prevention of influenza: A systematic review. Front Public Health 2022; 10:978456. [PMID: 36203669 PMCID: PMC9530567 DOI: 10.3389/fpubh.2022.978456] [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: 06/26/2022] [Accepted: 08/30/2022] [Indexed: 01/25/2023] Open
Abstract
Introduction Seasonal influenza, a contagious viral disease affecting the upper respiratory tract, circulates annually, causing considerable morbidity and mortality. The present study investigates the effectiveness of educational interventions to prevent influenza. Methods We searched PubMed/Medline, Embase, and Cochrane Controlled Register of Trials (CENTRAL) for relevant clinical studies up to March 1 2022. The following terms were used: "influenza," "flu," "respiratory infection," "prevent," "intervention," and "education." Results Out of 255 studies, 21 articles satisfied the inclusion criteria and were included in our study: 13 parallel randomized controlled trials (RCT) studies, two cross-over RCT studies, two cohort studies, and four quasi-experimental studies. A total of approximately 12,500 adults (18 years old or above) and 11,000 children were evaluated. Educational sessions and reminders were the most common interventions. The measured outcomes were vaccination rates, the incidence of respiratory tract infection (RTI), and preventive behaviors among participants. Eighteen out of 21 articles showed a significant association between educational interventions and the outcomes. Conclusions The included studies in the current systematic review reported the efficacy of health promotion educational interventions in improving knowledge about influenza, influenza prevention behaviors, vaccination rates, and decreased RTI incidence regardless of the type of intervention and the age of cases.
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Affiliation(s)
- Mohammad Javad Nasiri
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Mohammad Javad Nasiri
| | - Bardia Danaei
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Niloofar Deravi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Amir Hashem Shahidi Bonjar
- Clinician Scientist of Dental Materials and Restorative Dentistry, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zohreh Khoshgoftar
- Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Zohreh Khoshgoftar
| | - Forouzan Karimi
- Department of Immunology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran,*Correspondence: Forouzan Karimi
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Hilton J, Riley H, Pellis L, Aziza R, Brand SPC, K. Kombe I, Ojal J, Parisi A, Keeling MJ, Nokes DJ, Manson-Sawko R, House T. A computational framework for modelling infectious disease policy based on age and household structure with applications to the COVID-19 pandemic. PLoS Comput Biol 2022; 18:e1010390. [PMID: 36067212 PMCID: PMC9481179 DOI: 10.1371/journal.pcbi.1010390] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 09/16/2022] [Accepted: 07/14/2022] [Indexed: 11/18/2022] Open
Abstract
The widespread, and in many countries unprecedented, use of non-pharmaceutical interventions (NPIs) during the COVID-19 pandemic has highlighted the need for mathematical models which can estimate the impact of these measures while accounting for the highly heterogeneous risk profile of COVID-19. Models accounting either for age structure or the household structure necessary to explicitly model many NPIs are commonly used in infectious disease modelling, but models incorporating both levels of structure present substantial computational and mathematical challenges due to their high dimensionality. Here we present a modelling framework for the spread of an epidemic that includes explicit representation of age structure and household structure. Our model is formulated in terms of tractable systems of ordinary differential equations for which we provide an open-source Python implementation. Such tractability leads to significant benefits for model calibration, exhaustive evaluation of possible parameter values, and interpretability of results. We demonstrate the flexibility of our model through four policy case studies, where we quantify the likely benefits of the following measures which were either considered or implemented in the UK during the current COVID-19 pandemic: control of within- and between-household mixing through NPIs; formation of support bubbles during lockdown periods; out-of-household isolation (OOHI); and temporary relaxation of NPIs during holiday periods. Our ordinary differential equation formulation and associated analysis demonstrate that multiple dimensions of risk stratification and social structure can be incorporated into infectious disease models without sacrificing mathematical tractability. This model and its software implementation expand the range of tools available to infectious disease policy analysts.
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Affiliation(s)
- Joe Hilton
- School of Life Sciences, University of Warwick, Coventry, United Kingdom
- Zeeman Institue (SBIDER), University of Warwick, Coventry, United Kingdom
- * E-mail:
| | - Heather Riley
- Department of Mathematics, University of Manchester, Manchester, United Kingdom
| | - Lorenzo Pellis
- Department of Mathematics, University of Manchester, Manchester, United Kingdom
- The Alan Turing Institute for Data Science and Artificial Intelligence, London, United Kingdom
| | - Rabia Aziza
- School of Life Sciences, University of Warwick, Coventry, United Kingdom
- Zeeman Institue (SBIDER), University of Warwick, Coventry, United Kingdom
| | - Samuel P. C. Brand
- School of Life Sciences, University of Warwick, Coventry, United Kingdom
- Zeeman Institue (SBIDER), University of Warwick, Coventry, United Kingdom
- Kenya Medical Research Institute - Wellcome Trust Research Programme, Kilifi, Kenya
| | - Ivy K. Kombe
- Kenya Medical Research Institute - Wellcome Trust Research Programme, Kilifi, Kenya
| | - John Ojal
- Kenya Medical Research Institute - Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Andrea Parisi
- School of Life Sciences, University of Warwick, Coventry, United Kingdom
- Zeeman Institue (SBIDER), University of Warwick, Coventry, United Kingdom
| | - Matt J. Keeling
- School of Life Sciences, University of Warwick, Coventry, United Kingdom
- Zeeman Institue (SBIDER), University of Warwick, Coventry, United Kingdom
- Mathematics Institute, University of Warwick, Coventry, United Kingdom
| | - D. James Nokes
- School of Life Sciences, University of Warwick, Coventry, United Kingdom
- Zeeman Institue (SBIDER), University of Warwick, Coventry, United Kingdom
- Kenya Medical Research Institute - Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Thomas House
- Department of Mathematics, University of Manchester, Manchester, United Kingdom
- The Alan Turing Institute for Data Science and Artificial Intelligence, London, United Kingdom
- IBM Research Europe, Hartree Centre, Daresbury, United Kingdom
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19
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Faudrait-il garder les masques en milieu de travail ? ARCH MAL PROF ENVIRO 2022. [PMCID: PMC9482429 DOI: 10.1016/j.admp.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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20
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Bueno de Mesquita J. Airborne Transmission and Control of Influenza and Other Respiratory Pathogens. Infect Dis (Lond) 2022. [DOI: 10.5772/intechopen.106446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Despite uncertainty about the specific transmission risk posed by airborne, spray-borne, and contact modes for influenza, SARS-CoV-2, and other respiratory viruses, there is evidence that airborne transmission via inhalation is important and often predominates. An early study of influenza transmission via airborne challenge quantified infectious doses as low as one influenza virion leading to illness characterized by cough and sore throat. Other studies that challenged via intranasal mucosal exposure observed high doses required for similarly symptomatic respiratory illnesses. Analysis of the Evaluating Modes of Influenza Transmission (EMIT) influenza human-challenge transmission trial—of 52 H3N2 inoculated viral donors and 75 sero-susceptible exposed individuals—quantifies airborne transmission and provides context and insight into methodology related to airborne transmission. Advances in aerosol sampling and epidemiologic studies examining the role of masking, and engineering-based air hygiene strategies provide a foundation for understanding risk and directions for new work.
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21
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Effectiveness of Household Disinfection Techniques to Remove SARS-CoV-2 from Cloth Masks. Pathogens 2022; 11:pathogens11080916. [PMID: 36015037 PMCID: PMC9415727 DOI: 10.3390/pathogens11080916] [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: 07/07/2022] [Revised: 08/06/2022] [Accepted: 08/10/2022] [Indexed: 11/17/2022] Open
Abstract
To assess the efficacy of washing cloth masks, we simulated SARS-CoV-2 contamination in tricoline fabric and tested decontaminants to reduce viral particles. Viral suspensions using two variants (B.1.1.28 and P.1) were inoculated in these fabrics, and the inactivation kinetics were evaluated after washing with various household disinfection products (Soap powder, Lysoform®, Hypochlorite sodium and 70% Alcohol), rinse numbers, and exposure times. Afterward, the fabrics were washed in sterile water, and viral RNA was extracted and amplified using RT-qPCR. Finally, viral replication in cell cultures was examined. Our findings show that all biocidal treatments successfully disinfected the tissue tested. Some products showed less reduction in viral loads, such as soap powder (1.60 × 104, 1.04 × 103), soap powder and Lysoform® (1.60 × 104, 1.04 × 103), and alcohol 70% (1.02 × 103, 5.91 × 101), respectively. However, when sodium hypochlorite was used, this reduction was significantly increased (viral inactivation in 100% of the washes). After the first wash, the reduction in the number of viral particles was greater for the P.1 variant than for the B.1.1.28 variant (W = 51,759, p < 0.05). In conclusion, the role of sodium hypochlorite in cloth mask disinfection may also have implications for future health emergencies as well as recommendation by WHO.
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22
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Liu Q, Lin B, Zhu C, Hu J. Emergency hospitalization caused by non-COVID-19 respiratory diseases before and during the COVID-19 pandemic: A retrospective observational cohort study. Front Med (Lausanne) 2022; 9:929353. [PMID: 35991670 PMCID: PMC9385983 DOI: 10.3389/fmed.2022.929353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/14/2022] [Indexed: 11/25/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic as well as the subsequent prevention and control measures is like a quasi-experiment intervention that might have changed the features of emergency hospitalizations. Mortality is high in patient hospitalization due to emergency respiratory diseases (ERD). Therefore, we compared the characteristics of these patients before and during the pandemic. Exploring this issue might contribute to decision-making of emergency management when most of the resources and attention has been devoted to combat COVID-19. Methods This study was a retrospective observational cohort study. All emergency hospitalizations due to ERD from January 1, 2019 to December 31, 2020 in a tertiary hospital in China were included. Data including patients’ age, sex, and clinical outcomes were extracted. Air quality was collected from the official online platform. Clinical characteristics were compared and odds ratios were calculated. Results The ERD hospitalization rate was lower in 2020 than in 2019 (6.4 vs. 4.3%, χ2 = 55.449, P = 0.000) with a 50.65% reduction; however, the patients were older in 2020 than in 2019 (P = 0.000) with a higher proportion of admission to the intensive care unit (ICU) (46 vs. 33.5%, χ2 = 20.423, P = 0.000) and a longer ICU stay (P = 0.000). The overall intubation rate, hospital mortality, and rate of discharge due to ineffective treatment in 2020 were higher than those in 2019 (15.6 vs. 8%, χ2 = 18.578, P = 0.000; 4.2 vs. 1.1%, χ2 = 4.122, P = 0.000; 5.5 vs. 2.4%, χ2 = 8.93, P = 0.000, respectively). The logistic regression analysis indicated hospitalizations due to ERD were mainly associated with PM2.5 and sulfur dioxide on the day, and on the 4th and 5th days before admission (P = 0.034 and 0.020, 0.021 and 0.000, 0.028, and 0.027, respectively) in 2019. However, in 2020, the relationship between parameters of air quality and hospitalization changed. Conclusion The COVID-19 pandemic has changed the characteristics of emergency hospitalization due to ERD with a larger proportion of severe patients and poorer prognosis. The effect of air quality on emergencies were weakened. During the COVID-19 pandemic, it is necessary to pay more attention to the non-COVID-19 emergency patients.
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Affiliation(s)
- Qi Liu
- Department of Emergency Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Translational Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Qi Liu,
| | - Bingcao Lin
- Department of Emergency Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Translational Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Changju Zhu
- Department of Emergency Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Medical Key Laboratory of Emergency and Trauma Research, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jianping Hu
- Department of Clinical Evaluation, Henan Medical Association, Zhengzhou, China
- Jianping Hu,
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Gozdzielewska L, Kilpatrick C, Reilly J, Stewart S, Butcher J, Kalule A, Cumming O, Watson J, Price L. The effectiveness of hand hygiene interventions for preventing community transmission or acquisition of novel coronavirus or influenza infections: a systematic review. BMC Public Health 2022; 22:1283. [PMID: 35780111 PMCID: PMC9250256 DOI: 10.1186/s12889-022-13667-y] [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: 09/30/2021] [Accepted: 06/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Novel coronaviruses and influenza can cause infection, epidemics, and pandemics. Improving hand hygiene (HH) of the general public is recommended for preventing these infections. This systematic review examined the effectiveness of HH interventions for preventing transmission or acquisition of such infections in the community. METHODS PubMed, MEDLINE, CINAHL and Web of Science databases were searched (January 2002-February 2022) for empirical studies related to HH in the general public and to the acquisition or transmission of novel coronavirus infections or influenza. Studies on healthcare staff, and with outcomes of compliance or absenteeism were excluded. Study selection, data extraction and quality assessment, using the Cochrane Effective Practice and Organization of Care risk of bias criteria or Joanna Briggs Institute Critical Appraisal checklists, were conducted by one reviewer, and double-checked by another. For intervention studies, effect estimates were calculated while the remaining studies were synthesised narratively. The protocol was pre-registered (PROSPERO 2020: CRD42020196525). RESULTS Twenty-two studies were included. Six were intervention studies evaluating the effectiveness of HH education and provision of products, or hand washing against influenza. Only two school-based interventions showed a significant protective effect (OR: 0.64; 95% CI 0.51, 0.80 and OR: 0.40; 95% CI 0.22, 0.71), with risk of bias being high (n = 1) and unclear (n = 1). Of the 16 non-intervention studies, 13 reported the protective effect of HH against influenza, SARS or COVID-19 (P < 0.05), but risk of bias was high (n = 7), unclear (n = 5) or low (n = 1). However, evidence in relation to when, and how frequently HH should be performed was inconsistent. CONCLUSIONS To our knowledge, this is the first systematic review of effectiveness of HH for prevention of community transmission or acquisition of respiratory viruses that have caused epidemics or pandemics, including SARS-CoV-1, SARS-CoV-2 and influenza viruses. The evidence supporting the protective effect of HH was heterogeneous and limited by methodological quality; thus, insufficient to recommend changes to current HH guidelines. Future work is required to identify in what circumstances, how frequently and what product should be used when performing HH in the community and to develop effective interventions for promoting these specific behaviours in communities during epidemics.
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Affiliation(s)
- Lucyna Gozdzielewska
- Department of Nursing and Community Health, Research Centre for Health, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK.
| | | | - Jacqui Reilly
- Department of Nursing and Community Health, Research Centre for Health, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK
| | - Sally Stewart
- Department of Nursing and Community Health, Research Centre for Health, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK
| | - John Butcher
- Department of Nursing and Community Health, Research Centre for Health, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK
| | - Andrew Kalule
- Department of Nursing and Community Health, Research Centre for Health, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK
| | - Oliver Cumming
- Department of Disease Control, Faculty of Infectious Tropical Disease, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Julie Watson
- Department of Disease Control, Faculty of Infectious Tropical Disease, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Lesley Price
- Department of Nursing and Community Health, Research Centre for Health, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK
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Zhao S, Chong MKC, Ryu S, Guo Z, He M, Chen B, Musa SS, Wang J, Wu Y, He D, Wang MH. Characterizing superspreading potential of infectious disease: Decomposition of individual transmissibility. PLoS Comput Biol 2022; 18:e1010281. [PMID: 35759509 PMCID: PMC9269899 DOI: 10.1371/journal.pcbi.1010281] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 07/08/2022] [Accepted: 06/06/2022] [Indexed: 11/18/2022] Open
Abstract
In the context of infectious disease transmission, high heterogeneity in individual infectiousness indicates that a few index cases can generate large numbers of secondary cases, a phenomenon commonly known as superspreading. The potential of disease superspreading can be characterized by describing the distribution of secondary cases (of each seed case) as a negative binomial (NB) distribution with the dispersion parameter, k. Based on the feature of NB distribution, there must be a proportion of individuals with individual reproduction number of almost 0, which appears restricted and unrealistic. To overcome this limitation, we generalized the compound structure of a Poisson rate and included an additional parameter, and divided the reproduction number into independent and additive fixed and variable components. Then, the secondary cases followed a Delaporte distribution. We demonstrated that the Delaporte distribution was important for understanding the characteristics of disease transmission, which generated new insights distinct from the NB model. By using real-world dataset, the Delaporte distribution provides improvements in describing the distributions of COVID-19 and SARS cases compared to the NB distribution. The model selection yielded increasing statistical power with larger sample sizes as well as conservative type I error in detecting the improvement in fitting with the likelihood ratio (LR) test. Numerical simulation revealed that the control strategy-making process may benefit from monitoring the transmission characteristics under the Delaporte framework. Our findings highlighted that for the COVID-19 pandemic, population-wide interventions may control disease transmission on a general scale before recommending the high-risk-specific control strategies. Superspreading is one of the key transmission features of many infectious diseases and is considered a consequence of the heterogeneity in infectiousness of individual cases. To characterize the superspreading potential, we divided individual infectiousness into two independent and additive components, including a fixed baseline and a variable part. Such decomposition produced an improvement in the fit of the model explaining the distribution of real-world datasets of COVID-19 and SARS that can be captured by the classic statistical tests. Disease control strategies may be developed by monitoring the characteristics of superspreading. For the COVID-19 pandemic, population-wide interventions are suggested first to limit the transmission at a scale of general population, and then high-risk-specific control strategies are recommended subsequently to lower the risk of superspreading.
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Affiliation(s)
- Shi Zhao
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
- CUHK Shenzhen Research Institute, Shenzhen, China
- * E-mail: (SZ); (DH)
| | - Marc K. C. Chong
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
- CUHK Shenzhen Research Institute, Shenzhen, China
| | - Sukhyun Ryu
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, South Korea
| | - Zihao Guo
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
| | - Mu He
- Department of Foundational Mathematics, Xi’an Jiaotong-Liverpool University, Suzhou, China
| | - Boqiang Chen
- Department of Applied Mathematics, Hong Kong Polytechnic University, Hong Kong, China
| | - Salihu S. Musa
- Department of Applied Mathematics, Hong Kong Polytechnic University, Hong Kong, China
- Department of Mathematics, Kano University of Science and Technology, Wudil, Nigeria
| | - Jingxuan Wang
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
| | - Yushan Wu
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
| | - Daihai He
- Department of Applied Mathematics, Hong Kong Polytechnic University, Hong Kong, China
- * E-mail: (SZ); (DH)
| | - Maggie H. Wang
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
- CUHK Shenzhen Research Institute, Shenzhen, China
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Alqahtani JS, Aldhahir AM, AlRabeeah SM, Alsenani LB, Alsharif HM, Alshehri AY, Alenazi MM, Alnasser M, Alqahtani AS, AlDraiwiesh IA, Alghamdi SM, Siraj RA, Alqahtani HS, Sreedharan JK, Alqahtani AS, Alzahrani EM. Future Acceptability of Respiratory Virus Infection Control Interventions in General Population to Prevent Respiratory Infections. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58070838. [PMID: 35888557 PMCID: PMC9318605 DOI: 10.3390/medicina58070838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 12/23/2022]
Abstract
Background and Objectives: In both pandemic and non-pandemic situations, nonpharmaceutical public health measures may offer easy, low-cost, and effective means of reducing the spread and impact of acute respiratory infections. It is unknown whether such measures would be acceptable to the Saudi community beyond the current pandemic. Materials and Methods: A validated survey was used to test community acceptance of the measures. Respondents were asked which infection control practices they planned to maintain and which they believed should be policies for the community as a whole after the COVID-19 pandemic has subsided. Results: The survey was completed by 2057 people (95% completion rate), 1486 (72%) of whom were female, 259 (12.5%) of whom were current smokers, and 72 (3.5%) of whom had chronic lung disease. The most prevalent age groups were 18−30 years (933; 45.4%) and 31−40 years (483; 23.5%), with 641 individuals over 40 years old. Of the responses, 93% indicated that they would continue washing their hands more often; 92% wanted both clinicians and patients to wear masks in hospitals; 86% would continue avoiding smoking in indoor and outdoor areas; 73% would continue wearing a face covering on public transportation; 70% indicated that they would continue wearing a face covering in indoor public places. Regarding the respiratory virus infection control measures, 85% (11/13) received significant support (≥70% acceptability level) for continuation as policies in the future. Wearing face coverings outdoors and social distancing outdoors received little support (45% and 66%, respectively). Of the respiratory virus infection control measures, 54% received less support from current smokers than non-smokers (acceptability level < 70%). People with chronic respiratory disease supported 77% of the measures being regarded as policies in the future. Conclusion: The Saudi community supports nonpharmacological respiratory infection control measures that reduce the likelihood of infection. Public health campaigns should target smokers to increase awareness of the importance of these measures in lowering infections. Based on the findings of this study, nonpharmacological treatments should be presented and included in future recommendations for both the public and patients diagnosed with chronic respiratory diseases.
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Affiliation(s)
- Jaber S. Alqahtani
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam 34313, Saudi Arabia; (L.B.A.); (H.M.A.); (A.Y.A.); (M.M.A.); (M.A.); (A.S.A.); (I.A.A.); (J.K.S.); (A.S.A.)
- Correspondence: (J.S.A.); (S.M.A.)
| | - Abdulelah M. Aldhahir
- Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia;
| | - Saad M. AlRabeeah
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam 34313, Saudi Arabia; (L.B.A.); (H.M.A.); (A.Y.A.); (M.M.A.); (M.A.); (A.S.A.); (I.A.A.); (J.K.S.); (A.S.A.)
- Correspondence: (J.S.A.); (S.M.A.)
| | - Lujain B. Alsenani
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam 34313, Saudi Arabia; (L.B.A.); (H.M.A.); (A.Y.A.); (M.M.A.); (M.A.); (A.S.A.); (I.A.A.); (J.K.S.); (A.S.A.)
| | - Haifa M. Alsharif
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam 34313, Saudi Arabia; (L.B.A.); (H.M.A.); (A.Y.A.); (M.M.A.); (M.A.); (A.S.A.); (I.A.A.); (J.K.S.); (A.S.A.)
| | - Amani Y. Alshehri
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam 34313, Saudi Arabia; (L.B.A.); (H.M.A.); (A.Y.A.); (M.M.A.); (M.A.); (A.S.A.); (I.A.A.); (J.K.S.); (A.S.A.)
| | - Mayadah M. Alenazi
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam 34313, Saudi Arabia; (L.B.A.); (H.M.A.); (A.Y.A.); (M.M.A.); (M.A.); (A.S.A.); (I.A.A.); (J.K.S.); (A.S.A.)
| | - Musallam Alnasser
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam 34313, Saudi Arabia; (L.B.A.); (H.M.A.); (A.Y.A.); (M.M.A.); (M.A.); (A.S.A.); (I.A.A.); (J.K.S.); (A.S.A.)
| | - Ahmed S. Alqahtani
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam 34313, Saudi Arabia; (L.B.A.); (H.M.A.); (A.Y.A.); (M.M.A.); (M.A.); (A.S.A.); (I.A.A.); (J.K.S.); (A.S.A.)
| | - Ibrahim A. AlDraiwiesh
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam 34313, Saudi Arabia; (L.B.A.); (H.M.A.); (A.Y.A.); (M.M.A.); (M.A.); (A.S.A.); (I.A.A.); (J.K.S.); (A.S.A.)
| | - Saeed M. Alghamdi
- Clinical Technology Department, Respiratory Care Program, College of Applied Medical Sciences, Umm Al-Qura University, Makkah 21961, Saudi Arabia;
- National Heart and Lung Institute, Imperial College London, London SW7 2BX, UK
| | - Rayan A. Siraj
- Respiratory Therapy Department, King Faisal University, Al-Ahsa 31982, Saudi Arabia;
| | - Hussain S. Alqahtani
- Department of Clinical Laboratory Sciences, Prince Sultan Military College of Health Sciences, Dammam 34313, Saudi Arabia;
| | - Jithin K. Sreedharan
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam 34313, Saudi Arabia; (L.B.A.); (H.M.A.); (A.Y.A.); (M.M.A.); (M.A.); (A.S.A.); (I.A.A.); (J.K.S.); (A.S.A.)
| | - Abdullah S. Alqahtani
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam 34313, Saudi Arabia; (L.B.A.); (H.M.A.); (A.Y.A.); (M.M.A.); (M.A.); (A.S.A.); (I.A.A.); (J.K.S.); (A.S.A.)
| | - Eidan M. Alzahrani
- Physical Therapy Department, Prince Sultan Military College of Health Sciences, Dammam 34313, Saudi Arabia;
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Liu N, Ye M, Zhu Q, Chen D, Xu M, He J, Li Q, Li J. Adverse Reactions to Facemasks in Health-Care Workers: A Cross-Sectional Survey. Clin Cosmet Investig Dermatol 2022; 15:947-954. [PMID: 35642175 PMCID: PMC9148581 DOI: 10.2147/ccid.s365390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 05/17/2022] [Indexed: 11/23/2022]
Abstract
Background Coronavirus disease 2019 (COVID-19) has developed into a worldwide pandemic, which presents several challenges for frontline health-care workers (HCWs). HCWs are highly prone to various skin diseases due to prolonged use of personal protective equipment (PPE). The most frequently used type of PPE is facemasks. To effectively control adverse skin reactions, there is an urgent need for a range of preventive practices. Methods This cross-sectional study was conducted at 12 hospitals in Zhejiang province, China. HCWs were invited to participate in the web survey. Data were extracted by two independent reviewers using a predesigned data collection form and analyzed with SPSS 20.0. Results A total of 1147 questionnaires were collected, and of these, 1090 (95.03%) were valid and returned. The incidence of chest tightness and shortness of breath and face eczema was significantly higher in HCWs wearing N95 facemasks (41.91%; 31.62%) than in the HCWs wearing medical facemasks (38.05%, P = 0.010; 21.91%, P = 0.012). The incidence of ear pain and indentation was significantly higher in HCWs wearing hang-facemasks (83.81%) than in HCWs wearing strains-facemasks (61.19%, P < 0.001). The incidence of ear pain and indentation was significantly higher in HCWs wearing undiscriminating size code facemasks (79.88%) than in the HCWs wearing discriminating size code facemasks (67.86%, P = 0.031). There was a significant reduction (P < 0.001) in the incidence of HCWs without adverse reactions (ADRs) with increasing time wearing facemasks. Conclusion Incidence of ADRs does not significantly increase with the durations of mask wear where wearing mask time exceeded 4 hours per day. The medical staff generally wore masks for more than 4 hours per day; therefore, we recommend taking 15 min of rest after 2 hours of mask-wearing. Results in this study support the conclusion that the type of strain-facemasks and discriminating size code facemasks has a lower incidence of ADRs than other type of medical facemasks.
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Affiliation(s)
- Ning Liu
- Outpatient Department, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang Province, 314000, People's Republic of China
| | - Min Ye
- Nursing Department, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang Province, 314000, People's Republic of China
| | - Qinya Zhu
- Nursing Department, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang Province, 314000, People's Republic of China
| | - Dingchao Chen
- Medical Department, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang Province, 314000, People's Republic of China
| | - Mingmin Xu
- Ultrasonic Department, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang Province, 314000, People's Republic of China
| | - Jia He
- Department of Urology, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang Province, 314000, People's Republic of China
| | - Qian Li
- Ultrasonic Department, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang Province, 314000, People's Republic of China
| | - Jie Li
- The Health Administration Center, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang Province, 314000, People's Republic of China
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Pham TM, Yin M, Cooper BS. The potential impact of intensified community hand hygiene interventions on respiratory tract infections: a modelling study. Proc Math Phys Eng Sci 2022; 478:20210746. [PMID: 35582391 PMCID: PMC9092223 DOI: 10.1098/rspa.2021.0746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 04/07/2022] [Indexed: 12/02/2022] Open
Abstract
Hand hygiene is among the most fundamental and widely used behavioural measures to reduce the person-to-person spread of human pathogens and its effectiveness as a community intervention is supported by evidence from randomized trials. However, a theoretical understanding of the relationship between hand hygiene frequency and change in risk of infection is lacking. Using a simple model-based framework for understanding the determinants of hand hygiene effectiveness in preventing viral respiratory tract infections, we show that a crucial, but overlooked, determinant of the relationship between hand hygiene frequency and risk of infection via indirect transmission is persistence of viable virus on hands. If persistence is short, as has been reported for influenza, hand-washing needs to be performed very frequently or immediately after hand contamination to substantially reduce the probability of infection. When viable virus survival is longer (e.g. in the presence of mucus or for some enveloped viruses) less frequent hand washing can substantially reduce the infection probability. Immediate hand washing after contamination is consistently more effective than at fixed-time intervals. Our study highlights that recommendations on hand hygiene should be tailored to persistence of viable virus on hands and that more detailed empirical investigations are needed to help optimize this key intervention.
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Affiliation(s)
- Thi Mui Pham
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Mo Yin
- Oxford Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
- Division of Infectious Diseases, University Medicine Cluster, National University Hospital of Singapore, Singapore
| | - Ben S. Cooper
- Oxford Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
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Zhao H, Jatana S, Bartoszko J, Loeb M. Nonpharmaceutical interventions to prevent viral respiratory infection in community settings: an umbrella review. ERJ Open Res 2022; 8:00650-2021. [PMID: 35651370 PMCID: PMC9149389 DOI: 10.1183/23120541.00650-2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 03/29/2022] [Indexed: 01/08/2023] Open
Abstract
BackgroundRespiratory viruses pose an important public health threat to most communities. Nonpharmaceutical interventions (NPIs) such as masks, hand hygiene or physical distancing, among others, are believed to play an important role in reducing transmission of respiratory viruses. In this umbrella review, we summarise the evidence of the effectiveness of NPIs for the prevention of respiratory virus transmission in the community setting.ObservationsA systematic search of PubMed, Embase, Medline and Cochrane reviews resulted in a total of 24 studies consisting of 11 systematic reviews and meta-analyses, 12 systematic reviews without meta-analyses and one standalone meta-analysis. The current evidence from these data suggests that hand hygiene is protective against respiratory viral infection. The use of hand hygiene and facemasks, facemasks alone and physical distancing were interventions with inconsistent evidence. Interventions such as school closures, oral hygiene or nasal saline rinses were shown to be effective in reducing the risk of influenza; however, the evidence is sparse and mostly of low and critically low quality.ConclusionsStudies on the effectiveness of NPIs for the prevention of respiratory viral transmission in the community vary in study design, quality and reported effectiveness. Evidence for the use of hand hygiene or facemasks is the strongest; therefore, the most reasonable suggestion is to use hand hygiene and facemasks in the community setting.
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Braga F, Espinosa G, Monteiro A, Marinho B, Drummond E. Physiological Effects of Exercising at Different Intensities Wearing Surgical or Double-layer Cotton Facemasks Compared to Not Wearing a Mask. Eur J Sport Sci 2022; 23:925-935. [PMID: 35418276 DOI: 10.1080/17461391.2022.2065928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Since the beginning of the SARS-CoV-2 pandemic, the community use of facemasks has been widely recommended. However, their use during exercise has raised safety concerns. Thus, we compared the physiological differences between exercising wearing a surgical (SM) or a double-layer-cotton (DLC) facemask and not wearing a mask (NM). Sixteen volunteers underwent 4 bouts of cycling-based exercise, which consisted of two different intensities: light-to-moderate and moderate-to-high. Facemasks were used as follows: bout-1 and 4: NM; bout-2: SM or DLC and bout-3: DLC or SM. Ventilatory, metabolic, pulmonary gas exchange (PGE) and perceptual variables were collected. At both exercise intensities compared to NM, both facemasks induced similar ventilatory adaptations, increasing inspiratory time and tidal volume and decreasing breathing frequency. Effect sizes (ES) were larger for DLC than for SM. At moderate-to-high, both facemasks reduced the minute ventilation, whereas at light-to-moderate, it was only seen with DLC. End tidal and mixed CO2 pressures, as well as the difference between them, increased with both facemasks. Again, ES was larger for DLC than SM. No relevant oxygen saturation drop was observed with both facemaks and exercise intensities. A small ES increament in VO2 and VCO2 were seen with both facemasks. Effort perception increased at moderate-to-high for both exercise intensities, buth larger EF were with DLC than SM . DLC increased facial temperature during both exercise intensities. In conclusion, ventilatory adjustments imposed during facemask exercise influenced PGE and metabolic and perceptual changes. Larger ES were mostly seen for DLC than SM.Novelty Bullets Facemasks affect the breathing pattern by changing the frequency and amplitude of pulmonary ventilation.The augmented ventilatory work increases VO2, VCO2, and RPE and promotes nonconcerning drops in SpO2 and CO2 retention.Increased inspiratory and expiratory pressure can account for the reduction in pulmonary physiological dead space.
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Affiliation(s)
- Fabrício Braga
- Human Performance Laboratory; Rio de Janeiro; Brazil.,Casa de Saúde São José; Rio de Janeiro; Brazil
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Supporting Immunization Uptake during a Pandemic, Using Remote Phone Call Intervention among Babies Discharged from a Special Neonatal Care Unit (SNCU) in South India. Vaccines (Basel) 2022; 10:vaccines10040507. [PMID: 35455256 PMCID: PMC9025928 DOI: 10.3390/vaccines10040507] [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: 02/08/2022] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 02/04/2023] Open
Abstract
COVID-19 has impacted children’s immunization rates, putting the lives of children at risk. The present study assesses the impact of phone-call counseling, on immunization uptake during the pandemic. Families of babies discharged from the SNCUs in six government centers in three South Indian states were recruited. Calls were made 10 days after the immunization due date. Missed vaccinees were counseled and followed up on 7 and 15 days. Of 2313 contacted, 2097 completed the survey. Respondents were mostly mothers (88.2%), poor (67.5%), and had secondary level education (37.4%). Vaccinations were missed due to the baby’s poor health (64.1%), COVID-19 related concerns (32.6%), and lack of awareness (16.8%). At the end of the intervention, the immunization uptake increased from 65.2% to 88.2%. Phone-call intervention can safely support immunization and lower the burden on health workers.
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Rahman MZ, Hoque ME, Alam MR, Rouf MA, Khan SI, Xu H, Ramakrishna S. Face Masks to Combat Coronavirus (COVID-19)-Processing, Roles, Requirements, Efficacy, Risk and Sustainability. Polymers (Basel) 2022; 14:polym14071296. [PMID: 35406172 PMCID: PMC9003287 DOI: 10.3390/polym14071296] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 02/26/2022] [Accepted: 03/14/2022] [Indexed: 02/04/2023] Open
Abstract
Increasingly prevalent respiratory infectious diseases (e.g., COVID-19) have posed severe threats to public health. Viruses including coronavirus, influenza, and so on can cause respiratory infections. A pandemic may potentially emerge owing to the worldwide spread of the virus through persistent human-to-human transmission. However, transmission pathways may vary; respiratory droplets or airborne virus-carrying particles can have a key role in transmitting infections to humans. In conjunction with social distancing, hand cleanliness, and other preventative measures, the use of face masks is considered to be another scientific approach to combat ubiquitous coronavirus. Different types of face masks are produced using a range of materials (e.g., polypropylene, polyacrylonitrile, polycarbonate, polyurethane, polystyrene, polyester and polyethylene) and manufacturing techniques (woven, knitted, and non-woven) that provide different levels of protection to the users. However, the efficacy and proper disposal/management of the used face masks, particularly the ones made of non-biodegradable polymers, pose great environmental concerns. This review compiles the recent advancements of face masks, covering their requirements, materials and techniques used, efficacy, challenges, risks, and sustainability towards further enhancement of the quality and performance of face masks.
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Affiliation(s)
- Md Zillur Rahman
- Department of Mechanical Engineering, Ahsanullah University of Science and Technology (AUST), Dhaka 1208, Bangladesh
- Correspondence: (M.Z.R.); (M.E.H.); (H.X.)
| | - Md Enamul Hoque
- Department of Biomedical Engineering, Military Institute of Science and Technology (MIST), Dhaka 1216, Bangladesh;
- Correspondence: (M.Z.R.); (M.E.H.); (H.X.)
| | - Md Rubel Alam
- Department of Knitwear Manufacturing and Technology, BGMEA University of Fashion and Technology (BUFT), Dhaka 1230, Bangladesh; (M.R.A.); (M.A.R.)
| | - Md Abdur Rouf
- Department of Knitwear Manufacturing and Technology, BGMEA University of Fashion and Technology (BUFT), Dhaka 1230, Bangladesh; (M.R.A.); (M.A.R.)
| | - Saiful Islam Khan
- Department of Biomedical Engineering, Military Institute of Science and Technology (MIST), Dhaka 1216, Bangladesh;
| | - Huaizhong Xu
- Department of Biobased Materials Science, Kyoto Institute of Technology (KIT), Matsugasaki Hashikamicho 1, Sakyoku, Kyoto 606-8585, Japan
- Correspondence: (M.Z.R.); (M.E.H.); (H.X.)
| | - Seeram Ramakrishna
- Department of Mechanical Engineering, National University of Singapore (NUS), Singapore 117575, Singapore;
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The effect of hand hygiene frequency on reducing acute respiratory infections in the community - a meta-analysis. Epidemiol Infect 2022; 150:e79. [PMID: 35445655 PMCID: PMC9044525 DOI: 10.1017/s0950268822000516] [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] [Indexed: 11/21/2022] Open
Abstract
Hand hygiene is a simple, low-cost intervention that may lead to substantial population-level effects in suppressing acute respiratory infection epidemics. However, quantification of the efficacy of hand hygiene on respiratory infection in the community is lacking. We searched PubMed for randomised controlled trials on the effect of hand hygiene for reducing acute respiratory infections in the community published before 11 March 2021. We performed a meta-regression analysis using a Bayesian mixed-effects model. A total of 105 publications were identified, out of which six studies reported hand hygiene frequencies. Four studies were performed in household settings and two were in schools. The average number of handwashing events per day ranged from one to eight in the control arms, and four to 17 in the intervention arms. We estimated that a single hand hygiene event is associated with a 3% (80% credible interval (−1% to 7%)) decrease in the daily probability of an acute respiratory infection. Three of these six studies were potentially at high risk of bias because the primary outcome depended on self-reporting of upper respiratory tract symptoms. Well-designed trials with an emphasis on monitoring hand hygiene adherence are needed to confirm these findings.
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Fountoulakis KN, Breda J, Arletou MP, Charalampakis AI, Karypidou MG, Kotorli KS, Koutsoudi CG, Ladia ES, Mitkani CA, Mpouri VN, Samara AC, Stravoravdi AS, Tsiamis IG, Tzortzi A, Vamvaka MA, Zacharopoulou CN, Prezerakos PE, Koupidis SA, K Fountoulakis N, Tsapakis EM, Konsta A, Theodorakis PN. Adherence to facemask use in public places during the autumn-winter 2020 COVID-19 lockdown in Greece: observational data. Ann Gen Psychiatry 2022; 21:9. [PMID: 35264198 PMCID: PMC8905561 DOI: 10.1186/s12991-022-00386-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 02/22/2022] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Wearing facemasks is of proven efficacy as a public health protective measure against COVID-19. Currently there are no observational data concerning the wearing of facemasks and the adherence to guidelines concerning their handling. METHODS Registration of the way passers-by were wearing facemasks at 26 different locations of five major cities in Greece. The results were correlated with the rate of COVID-19 deaths in the region. RESULTS In total, 119,433 passers-by were registered, 57,043 females (47.8%) and 62,390 males (52.2%). From the total sample, 81.1% were wearing the mask properly, 10.8% had their nose out, 6.2% were wearing it under the jaw, and 1.9% had no mask at all . There was a significant difference between males and females concerning any use of mask. Inappropriate use of was correlated with COVID-19 death rate in the studied region. CONCLUSION Our findings suggest that under conditions of mandatory wearing and in central locations of major cities, during walking, proper use of masks is suboptimal, but still contributes with some protection. Fear and risk perception seem to be strong factors contributing to adherence to proper mask wearing.
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Affiliation(s)
- Konstantinos N Fountoulakis
- Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 6, Odysseos str, 55535, Thessaloniki, Greece
| | - Joao Breda
- WHO Athens Quality of Care Office, WHO Regional Office for Europe, Athens, Greece
| | - Marianna P Arletou
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anastasios I Charalampakis
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria G Karypidou
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantina S Kotorli
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christina G Koutsoudi
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleftheria S Ladia
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Calypso A Mitkani
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasiliki N Mpouri
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anastasia C Samara
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aikaterini S Stravoravdi
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis G Tsiamis
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aphrodite Tzortzi
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria A Vamvaka
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Charikleia N Zacharopoulou
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Panagiotis E Prezerakos
- Department of Nursing, Laboratory of Integrated Health Care, University of Peloponnese, Tripoli, Greece
| | - Sotirios A Koupidis
- Occupational & Environmental Health Sector, Public Health Policy Department, School of Public Health, University of West Attica, Athens, Greece
| | | | | | - Anastasia Konsta
- Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 6, Odysseos str, 55535, Thessaloniki, Greece
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Effectiveness of face masks in blocking the transmission of SARS-CoV-2: A preliminary evaluation of masks used by SARS-CoV-2-infected individuals. PLoS One 2022; 17:e0264389. [PMID: 35196363 PMCID: PMC8865648 DOI: 10.1371/journal.pone.0264389] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 02/09/2022] [Indexed: 12/18/2022] Open
Abstract
In 2019, a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is transmitted via the airborne route, caused a new pandemic namely, “coronavirus disease 2019” (COVID-19). Although the effectiveness of face masks to prevent the transmission of SARS-CoV-2 is debated, no study has evaluated the virus-blocking efficacy of masks used by patients. We aimed to evaluate this efficacy of masks used by SARS-CoV-2-infected individuals. Data, masks used, and nasopharyngeal swab samples were obtained from these patients. Forty-five paired samples of nasopharyngeal swabs and masks were obtained and processed; the majority of masks were woven. Viral RNAs were amplified using quantitative reverse‐transcription polymerase chain reaction and detected only on the inner parts of masks. Median viral load (VL) values of swabs and masks were 1.954x106 and 2,51x103, respectively. Statistically, there was a difference of approximately 1000 RNA copies/mL between swabs and masks and no significant difference in VL values among different types of masks. There were statistically significant differences in VL values between men and women and between symptomatic and asymptomatic patients. Our findings suggest the blocking of virus transmission by different types of masks and reinforce the use of masks by both infected and non-infected individuals.
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Effectiveness of Mask-Wearing on Respiratory Illness Transmission in Community Settings: A Rapid Review. Disaster Med Public Health Prep 2022; 17:e96. [PMID: 35249589 PMCID: PMC9623601 DOI: 10.1017/dmp.2021.369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Respiratory illnesses, including coronavirus disease 2019 (COVID-19), have resulted in millions of deaths globally. Guidance on mask-wearing in community settings has been inconsistent. This review examined the effectiveness of mask-wearing on respiratory virus transmission in community settings. METHODS A search was conducted for English language reports of randomized controlled trials of mask-wearing in the community and effect on laboratory-confirmed respiratory infections or influenza-like illness. Investigators abstracted study characteristics and assessed bias. Meta-analysis was conducted to calculate pooled risk estimates. RESULTS Eleven studies were included. In 7 studies that evaluated influenza-like illness symptoms as an outcome (3029 participants), this study found mask-wearing associated with a decreased risk of influenza-like illness (overall risk ratio [RR], 0.83; 95% confidence interval [CI], 0.71 to 0.96). Studies examining laboratory-confirmed respiratory infections as an outcome (10,531 participants) showed no statistically significant association between mask-wearing and infections (RR, 1.04; 95% CI, 0.60-1.80). However, masking combined with enhanced hand hygiene was associated with a decreased risk for both influenza-like illness symptoms (RR, 0.88; 95% CI, 0.51-1.51) and laboratory-confirmed respiratory infection (RR, 0.79; 95% CI, 0.52-1.18). CONCLUSIONS Masking in community settings decreases transmission of influenza-like illness. Mask-wearing combined with enhanced hand hygiene reduces transmission of influenza-like illness and laboratory-confirmed respiratory infection.
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The non-pharmaceutical interventions may affect the advantage in transmission of mutated variants during epidemics: A conceptual model for COVID-19. J Theor Biol 2022; 542:111105. [PMID: 35331730 PMCID: PMC8934756 DOI: 10.1016/j.jtbi.2022.111105] [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: 09/01/2021] [Revised: 03/15/2022] [Accepted: 03/18/2022] [Indexed: 11/25/2022]
Abstract
As the COVID-19 pandemic continues, genetic mutations in SARS-CoV-2 emerge, and some of them are found more contagious than the previously identified strains, acting as the major mechanism for many large-scale epidemics. The transmission advantage of mutated variants is widely believed as an innate biological feature that is difficult to be altered by artificial factors. In this study, we explore how non-pharmaceutical interventions (NPI) may affect transmission advantage. A two-strain compartmental epidemic model is proposed and simulated to investigate the biological mechanism of the relationships among different NPIs, the changes in transmissibility of each strain and transmission advantage. Although the NPIs are effective in flattening the epidemic curve, we demonstrate that NPIs probably lead to a decline in transmission advantage, which is likely to occur if the NPIs become intensive. Our findings uncover the mechanistic relationship between NPIs and transmission advantage dynamically, and highlight the important role of NPIs not only in controlling the intensity of epidemics but also in slowing or even containing the growth of the proportion of variants.
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Wang ML, Hung MH, Hsu HH, Cheng YJ, Chen JS. Non-intubated Thoracoscopic Surgery to Minimize Contamination From Airway Secretions During the COVID-19 Pandemic. Front Surg 2022; 9:818824. [PMID: 35252335 PMCID: PMC8894440 DOI: 10.3389/fsurg.2022.818824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 01/27/2022] [Indexed: 01/08/2023] Open
Abstract
Background General anesthesia and tracheal intubation potentially pose a high risk to health care workers (HCWs) managing surgical patients during the coronavirus disease 2019 (COVID-19) pandemic. Non-intubated anesthesia is a rational way of managing patients undergoing thoracoscopic surgery that avoids tracheal intubation and minimizes the aerosols generated during airway instrumentation. The purpose of this study was to determine whether non-intubated anesthesia in combination with a face mask is safe and feasible in patients undergoing thoracoscopic surgery. Methods A total of 18 patients who underwent non-intubated thoracoscopic surgery with a face mask during the perioperative period between March 9, 2020 and April 6, 2020 were included. The main outcomes were anesthetic management and postoperative results. Results The 18 patients had a mean age of 64 years and a body mass index of 22.9 kg/m2. All patients wore a mask during induction of anesthesia and throughout surgery. Three patients underwent lobectomy, four segmentectomy, ten wedge resection, and one underwent anterior mediastinal tumor resection. No patient developed cough or vomiting during the perioperative period. All patients were transferred to the postoperative recovery unit within 15 min of the end of surgery (average 7.2 min). No patient required conversion to tracheal intubation or conversion to thoracotomy. Conclusion Non-intubated anesthesia with a mask was safe and feasible in patients undergoing thoracoscopic surgery. Avoidance of intubated general anesthesia and use of a lung separation device may reduce the risk to HCWs of contamination by airway secretions, thereby conserving personal protective equipment, especially during the COVID-19 pandemic.
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Affiliation(s)
- Man-Ling Wang
- Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ming-Hui Hung
- Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hsao-Hsun Hsu
- Division of Thoracic Surgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ya-Jung Cheng
- Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Anesthesiology, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Jin-Shing Chen
- Division of Thoracic Surgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Surgical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
- *Correspondence: Jin-Shing Chen
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Theresa Christin Fendt M, Leal Filho W, Barbir J, Boenecke J. Perceived Effectiveness and Sustainability of Face Masks Among German Citizens During the 2nd Wave of the COVID-19 Pandemic—A Cross-Sectional Study. Front Public Health 2022. [DOI: 10.3389/fpubh.2022.768454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe COVID-19 pandemic, which began at the end of 2019, has led to a significant increase in the demand for face masks in Germany and around the globe. Since non-reusable masks are often not correctly disposed of and are not biodegradable, their increasing use harms the environment. Both the ongoing pandemic and the rising environmental pollution eventually pose a threat to human health. Yet, it is unclear whether mask users are conscious of this, and which factors influence their choice of face masks. This study investigates the user preferences, perceived effectiveness, and the sustainability of different mouth/nose protection (MNP) to lay the foundation for developing more sustainable and effective alternatives.MethodsA national (Germany-wide) cross-sectional study with a sample of 1,036 participants was conducted. Descriptive data analysis was deployed to describe trends and socio-demographic differences among the respondents. Different socio-demographic groups among the respondents were compared regarding their infection risk perception, compliance toward the use of personal protective measures, their choice of MNP, and knowledge level of sustainability and effectiveness of various MNP using inferential statistics (Chi2 test/Whitney–Mann-U-test/Kruskal–Wallis-test).ResultsThe results suggest that, in addition to protective effectiveness, the reusability of MNP is important to not just most respondents but especially to older participants. In contrast, the price, shape, and design were not as important. The knowledge level of the effectiveness and sustainability of MNP was high among the participants and was not associated with socioeconomic characteristics. However, the knowledge level directly influenced the choice of MNP.ConclusionThere seems to be an inclination to use sustainable MNP, provided their level of protection is similar to medical masks or FFP2/FFP3 masks. The willingness to wear a sustainable option increases with age.
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Bisanzio D, Reithinger R, Alqunaibet A, Almudarra S, Alsukait RF, Dong D, Zhang Y, El-Saharty S, Herbst CH. Estimating the effect of non-pharmaceutical interventions to mitigate COVID-19 spread in Saudi Arabia. BMC Med 2022; 20:51. [PMID: 35125108 PMCID: PMC8818364 DOI: 10.1186/s12916-022-02232-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 01/03/2022] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND The Kingdom of Saudi Arabia (KSA) quickly controlled the spread of SARS-CoV-2 by implementing several non-pharmaceutical interventions (NPIs), including suspension of international and national travel, local curfews, closing public spaces (i.e., schools and universities, malls and shops), and limiting religious gatherings. The KSA also mandated all citizens to respect physical distancing and to wear face masks. However, after relaxing some restrictions during June 2020, the KSA is now planning a strategy that could allow resuming in-person education and international travel. The aim of our study was to evaluate the effect of NPIs on the spread of the COVID-19 and test strategies to open schools and resume international travel. METHODS We built a spatial-explicit individual-based model to represent the whole KSA population (IBM-KSA). The IBM-KSA was parameterized using country demographic, remote sensing, and epidemiological data. A social network was created to represent contact heterogeneity and interaction among age groups of the population. The IBM-KSA also simulated the movement of people across the country based on a gravity model. We used the IBM-KSA to evaluate the effect of different NPIs adopted by the KSA (physical distancing, mask-wearing, and contact tracing) and to forecast the impact of strategies to open schools and resume international travels. RESULTS The IBM-KSA results scenarios showed the high effectiveness of mask-wearing, physical distancing, and contact tracing in controlling the spread of the disease. Without NPIs, the KSA could have reported 4,824,065 (95% CI: 3,673,775-6,335,423) cases by June 2021. The IBM-KSA showed that mandatory mask-wearing and physical distancing saved 39,452 lives (95% CI: 26,641-44,494). In-person education without personal protection during teaching would have resulted in a high surge of COVID-19 cases. Compared to scenarios with no personal protection, enforcing mask-wearing and physical distancing in schools reduced cases, hospitalizations, and deaths by 25% and 50%, when adherence to these NPIs was set to 50% and 70%, respectively. The IBM-KSA also showed that a quarantine imposed on international travelers reduced the probability of outbreaks in the country. CONCLUSIONS This study showed that the interventions adopted by the KSA were able to control the spread of SARS-CoV-2 in the absence of a vaccine. In-person education should be resumed only if NPIs could be applied in schools and universities. International travel can be resumed but with strict quarantine rules. The KSA needs to keep strict NPIs in place until a high fraction of the population is vaccinated in order to reduce hospitalizations and deaths.
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Affiliation(s)
- Donal Bisanzio
- RTI International, Washington, D.C., USA. .,Epidemiology and Public Health Division, School of Medicine, University of Nottingham, Nottingham, UK.
| | | | | | | | - Reem F Alsukait
- College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.,World Bank, Washington, D.C., USA
| | - Di Dong
- World Bank, Washington, D.C., USA
| | - Yi Zhang
- World Bank, Washington, D.C., USA
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Hibiya K, Iwata H, Kinjo T, Shinzato A, Tateyama M, Ueda S, Fujita J. Incidence of common infectious diseases in Japan during the COVID-19 pandemic. PLoS One 2022; 17:e0261332. [PMID: 35020724 PMCID: PMC8754328 DOI: 10.1371/journal.pone.0261332] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 11/29/2021] [Indexed: 11/18/2022] Open
Abstract
Recent reports indicate that respiratory infectious diseases were suppressed during the novel coronavirus disease-2019 (COVID-19) pandemic. COVID-19 led to behavioral changes aimed to control droplet transmission or contact transmission. In this study, we examined the incidence of common infectious diseases in Japan during the COVID-19 pandemic. COVID-19 data were extracted from the national data based on the National Epidemiological Surveillance of Infectious Diseases (NESID). Common infectious diseases were selected from notifiable infectious diseases under the NESID. The epidemic activity of the diseases during 2015-2020 was evaluated based on the Infectious Disease Weekly Reports published by the National Institute of Infectious Diseases. Each disease was then categorized according to the route of transmission. Many Japanese people had adopted hygienic activities, such as wearing masks and hand washing, even before the COVID-19 pandemic. We examined the correlation between the time-series of disease counts of common infectious diseases and COVID-19 over time using cross-correlation analysis. The weekly number of cases of measles, rotavirus, and several infections transmitted by droplet spread, was negatively correlated with the weekly number of cases of COVID-19 for up to 20 weeks in the past. According to the difference-in-differences analysis, the activity of influenza and rubella was significantly lower starting from the second week in 2020 than that in 2015-2019. Only legionellosis was more frequent throughout the year than in 2015-2019. Lower activity was also observed in some contact transmitted, airborne-transmitted, and fecal-oral transmitted diseases. However, carbapenem-resistant Enterobacteriaceae, exanthema subitum, showed the same trend as that over the previous 5 years. In conclusion, our study shows that public health interventions for the COVID-19 pandemic may have effectively prevented the transmission of most droplet-transmitted diseases and those transmitted through other routes.
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Affiliation(s)
- Kenji Hibiya
- Department of Infectious, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Nishihara-cho, Okinawa, Japan
- Department of Diagnostic Pathology, University of the Ryukyus Hospital, Nishihara-cho, Okinawa, Japan
- * E-mail:
| | - Hiroyoshi Iwata
- Clinical Pharmacology & Therapeutics, University of The Ryukyus School of Medicine, Nishihara-cho, Okinawa, Japan
| | - Takeshi Kinjo
- Department of Infectious, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Nishihara-cho, Okinawa, Japan
| | - Akira Shinzato
- Department of Infectious, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Nishihara-cho, Okinawa, Japan
| | - Masao Tateyama
- Department of Infectious, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Nishihara-cho, Okinawa, Japan
| | - Shinichiro Ueda
- Clinical Pharmacology & Therapeutics, University of The Ryukyus School of Medicine, Nishihara-cho, Okinawa, Japan
| | - Jiro Fujita
- Department of Infectious, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Nishihara-cho, Okinawa, Japan
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Wadud Z, Rahman SM, Enam A. Face mask mandates and risk compensation: an analysis of mobility data during the COVID-19 pandemic in Bangladesh. BMJ Glob Health 2022; 7:bmjgh-2021-006803. [PMID: 35012968 PMCID: PMC8753097 DOI: 10.1136/bmjgh-2021-006803] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 12/09/2021] [Indexed: 01/24/2023] Open
Abstract
Introduction Concerns have been raised about the potential for risk compensation in the context of mask mandates for mitigating the spread of COVID-19. However, the debate about the presence or absence of risk compensation for universal mandatory mask-wearing rules—especially in the context of COVID-19—is not settled yet. Methods Mobility is used as a proxy for risky behaviour before and after the mask mandates. Two sets of regressions are estimated to decipher (any) risk-compensating effect of mask mandate in Bangladesh. These include: (1) intervention regression analysis of daily activities at six types of locations, using pre-mask-mandate and post-mandate data; and (2) multiple regression analysis of daily new COVID-19 cases on daily mobility (lagged) to establish mobility as a valid proxy. Results (1) Statistically, mobility increased at all five non-residential locations, while home stays decreased after the mask mandate was issued; (2) daily mobility had a statistically significant association on daily new cases (with around 10 days of lag). Both significances were calculated at 95% confidence level. Conclusion Community mobility had increased (and stay at home decreased) after the mandatory mask-wearing rule, and given mobility is associated with increases in new COVID-19 cases, there is evidence of risk compensation effect of the mask mandate—at least partially—in Bangladesh.
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Affiliation(s)
- Zia Wadud
- Institute for Transport Studies & School of Chemical and Process Engineering, University of Leeds, Leeds, UK
| | - Sheikh Mokhlesur Rahman
- Department of Civil Engineering, Bangladesh University of Engineering and Technology, Dhaka, Bangladesh
| | - Annesha Enam
- Department of Civil Engineering, Bangladesh University of Engineering and Technology, Dhaka, Bangladesh
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Wang Q, Shi N, Huang J, Yang L, Cui T, Ai J, Ji H, Xu K, Ahmad T, Bao C, Jin H. Cost-Effectiveness of Public Health Measures to Control COVID-19 in China: A Microsimulation Modeling Study. Front Public Health 2022; 9:726690. [PMID: 35059369 PMCID: PMC8763804 DOI: 10.3389/fpubh.2021.726690] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 12/03/2021] [Indexed: 11/13/2022] Open
Abstract
This study aimed to assess the cost-effectiveness of various public health measures in dealing with coronavirus disease 2019 (COVID-19) in China. A stochastic agent-based model was used to simulate the progress of the COVID-19 outbreak in scenario I (imported one case) and scenario II (imported four cases) with a series of public health measures. The main outcomes included the avoided infections and incremental cost-effectiveness ratios (ICERs). Sensitivity analyses were performed to assess uncertainty. The results indicated that isolation-and-quarantine averted the COVID-19 outbreak at the lowest ICERs. The joint strategy of personal protection and isolation-and-quarantine averted one more case than only isolation-and-quarantine with additional costs. The effectiveness of isolation-and-quarantine decreased with lowering quarantine probability and increasing delay time. The strategy that included community containment would be cost-effective when the number of imported cases was >65, or the delay time of the quarantine was more than 5 days, or the quarantine probability was below 25%, based on current assumptions. In conclusion, isolation-and-quarantine was the most cost-effective intervention. However, personal protection combined with isolation-and-quarantine was the optimal strategy for averting more cases. The community containment could be more cost-effective as the efficiency of isolation-and-quarantine drops and the imported cases increases.
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Affiliation(s)
- Qiang Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Naiyang Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Jinxin Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Liuqing Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Tingting Cui
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Jing Ai
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Hong Ji
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Ke Xu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Tauseef Ahmad
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Changjun Bao
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Hui Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
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Ahsan I, Menon I, Gupta R, Arora V, Das D, Ashraf A. Impact of general hygiene behaviors on oral hygiene among adolescents of Ghaziabad - A cross-sectional study. JOURNAL OF INDIAN ASSOCIATION OF PUBLIC HEALTH DENTISTRY 2022. [DOI: 10.4103/jiaphd.jiaphd_163_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Affiliation(s)
- Aaron Lawson
- Department of Pharmacy, Truman Medical Center, Kansas City, Missouri, USA
| | - Angel López-Candales
- Cardiovascular Medicine Division, Truman Medical Center, University of Missouri-Kansas City, Kansas City, Missouri, USA
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Andrejko KL, Pry J, Myers JF, Openshaw J, Watt J, Birkett N, DeGuzman JL, Barbaduomo CM, Dong ZN, Fang AT, Frost PM, Ho T, Javadi MH, Li SS, Tran VH, Wan C, Jain S, Lewnard JA. Predictors of SARS-CoV-2 infection following high-risk exposure. Clin Infect Dis 2021; 75:e276-e288. [PMID: 34932817 PMCID: PMC8903328 DOI: 10.1093/cid/ciab1040] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Non-pharmaceutical interventions (NPIs) are recommended for COVID-19 prevention. However, the effectiveness of NPIs in preventing SARS-CoV-2 transmission remains poorly quantified. METHODS We conducted a test-negative design case-control study enrolling cases (testing positive for SARS-CoV-2) and controls (testing negative) with molecular SARS-CoV-2 diagnostic test results reported to California Department of Public Health between 24 February-12 November, 2021. We used conditional logistic regression to estimate adjusted odds ratios (aORs) of case status among participants who reported contact with an individual known or suspected to have been infected with SARS-CoV-2 ("high-risk exposure") ≤14 days before testing. RESULTS 751 of 1448 cases (52%) and 255 of 1443 controls (18%) reported high-risk exposures ≤14 days before testing. Adjusted odds of case status were 3.02-fold (95% confidence interval: 1.75-5.22) higher when high-risk exposures occurred with household members (vs. other contacts), 2.10-fold (1.05-4.21) higher when exposures occurred indoors (vs. outdoors only), and 2.15-fold (1.27-3.67) higher when exposures lasted ≥3 hours (vs. shorter durations) among unvaccinated and partially-vaccinated individuals; excess risk associated with such exposures was mitigated among fully-vaccinated individuals. Cases were less likely than controls to report mask usage during high-risk exposures (aOR=0.50 [0.29-0.85]). The adjusted odds of case status was lower for fully-vaccinated (aOR=0.25 [0.15-0.43]) participants compared to unvaccinated participants. Benefits of mask usage were greatest among unvaccinated and partially-vaccinated participants, and in interactions involving non-household contacts or interactions occurring without physical contact. CONCLUSIONS NPIs reduced the likelihood of SARS-CoV-2 infection following high-risk exposure. Vaccine effectiveness was substantial for partially and fully vaccinated persons.
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Affiliation(s)
- Kristin L Andrejko
- Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, California, United States
| | - Jake Pry
- California Department of Public Health, Richmond, California, United States
| | - Jennifer F Myers
- California Department of Public Health, Richmond, California, United States
| | - John Openshaw
- California Department of Public Health, Richmond, California, United States
| | - James Watt
- California Department of Public Health, Richmond, California, United States
| | - Nozomi Birkett
- California Department of Public Health, Richmond, California, United States
| | | | | | - Zheng N Dong
- California Department of Public Health, Richmond, California, United States
| | - Anna T Fang
- California Department of Public Health, Richmond, California, United States
| | - Paulina M Frost
- California Department of Public Health, Richmond, California, United States
| | - Timothy Ho
- California Department of Public Health, Richmond, California, United States
| | - Mahsa H Javadi
- California Department of Public Health, Richmond, California, United States
| | - Sophia S Li
- California Department of Public Health, Richmond, California, United States
| | - Vivian H Tran
- California Department of Public Health, Richmond, California, United States
| | - Christine Wan
- California Department of Public Health, Richmond, California, United States
| | - Seema Jain
- California Department of Public Health, Richmond, California, United States
| | - Joseph A Lewnard
- Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, California, United States.,Division of Infectious Diseases & Vaccinology, School of Public Health, University of California, Berkeley, California, United States.,Center for Computational Biology, College of Engineering, University of California, Berkeley, California, United States
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Change in Pediatric Health Care Spending and Drug Utilization during the COVID-19 Pandemic. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8121183. [PMID: 34943379 PMCID: PMC8699860 DOI: 10.3390/children8121183] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 11/26/2021] [Accepted: 12/09/2021] [Indexed: 12/23/2022]
Abstract
Objective: To evaluate how the restrictive measures implemented during the SARS-CoV-2 pandemic have influenced the incidence of the most common children’s diseases and the consumption of medications in 2020 compared to 2019. Methods: We involved all family pediatricians of the local health authority of Latina, from which we requested data of monthly visits in 2019 and 2020 for six common diseases disseminated through droplets and contact, and the territorial and integrative pharmaceutical unit of the area, from which we requested data of the net expenditure regarding the most commonly used drugs at pediatric age. Results: There was significant reduction in the incidence of the evaluated diseases and in the consumption of investigated drugs between 2019 and 2020 in the months when the restrictive measures were in place, with an attenuation of this effect during the months of the gradual loosening of those measures. Conclusion: Nonpharmaceutical intervention measures have caused changes in the diffusion of common pediatric diseases. We believe that the implementation of a reasonable containment strategy, even outside of the pandemic, could positively influence the epidemiology of infectious and allergic diseases in children, and healthcare system spending.
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Mun SK, Yang BR, Chang M. Changes in respiratory diseases in South Korea during the COVID-19 pandemic: an interrupted time series study. BMJ Glob Health 2021; 6:bmjgh-2021-006912. [PMID: 34887303 PMCID: PMC8662586 DOI: 10.1136/bmjgh-2021-006912] [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: 07/15/2021] [Accepted: 10/27/2021] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION In South Korea, non-pharmaceutical interventions such as mask-wearing, hand washing and social distancing were strictly implemented to prevent the spread of COVID-19 after a national crisis alert was raised to the highest level early in the pandemic (23 February 2020). We aimed to investigate changes in the occurrence of respiratory diseases at the national level after the COVID-19 outbreak. METHODS The study period was from 1 January to 1 August 2019 (213 days) and from 1 January to 31 July 2020 (213 days). Based on the National Health Insurance Service data, we analysed changes in the numbers of patients treated for respiratory diseases. The changes in the numbers of individuals using public transportation and visiting the theatre were investigated to assess the effect of social distancing after the national crisis alert was raised. Differences in daily cumulative numbers (DDCNs) in 2020 were calculated as follows: (daily cumulative number in 2020)-(cumulative number for that day in 2019). A change over time in DDCNs of <0 was taken as indication that the numbers decreased from 2019 to 2020. Segmented regression analyses were performed using generalised least squares method to identify changes in trends of DDCNs of patients treated for respiratory diseases and individuals using public transportation and visiting the theatre. RESULTS After the national crisis alert was raised to the highest level, DDCNs of patients treated for respiratory diseases, individuals using public transportation, and those visiting the theatre exhibited a significant daily decline by 53.18 per 10 000 inhabitants (95% CI -65.86 to -40.49), 48.19 per 1000 inhabitants (95% CI -62.05 to -34.32) and 25.30 per 5000 inhabitants (95% CI -36.30 to -14.30), respectively, compared with before the national crisis alert was raised. CONCLUSION Non-pharmaceutical interventions to prevent the spread of COVID-19 significantly reduce the incidence of respiratory diseases.
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Affiliation(s)
- Seog-Kyun Mun
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Bo Ram Yang
- College of Pharmacy, Chungnam National University, Daejeon, South Korea
| | - Munyoung Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, South Korea
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Chirgwin H, Cairncross S, Zehra D, Sharma Waddington H. Interventions promoting uptake of water, sanitation and hygiene (WASH) technologies in low- and middle-income countries: An evidence and gap map of effectiveness studies. CAMPBELL SYSTEMATIC REVIEWS 2021; 17:e1194. [PMID: 36951806 PMCID: PMC8988822 DOI: 10.1002/cl2.1194] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Background Lack of access to and use of water, sanitation and hygiene (WASH) cause 1.6 million deaths every year, of which 1.2 million are due to gastrointestinal illnesses like diarrhoea and acute respiratory infections like pneumonia. Poor WASH access and use also diminish nutrition and educational attainment, and cause danger and stress for vulnerable populations, especially for women and girls. The hardest hit regions are sub-Saharan Africa and South Asia. Sustainable Development Goal (SDG) 6 calls for the end of open defecation, and universal access to safely managed water and sanitation facilities, and basic hand hygiene, by 2030. WASH access and use also underpin progress in other areas such as SDG1 poverty targets, SDG3 health and SDG4 education targets. Meeting the SDG equity agenda to "leave none behind" will require WASH providers prioritise the hardest to reach including those living remotely and people who are disadvantaged. Objectives Decision makers need access to high-quality evidence on what works in WASH promotion in different contexts, and for different groups of people, to reach the most disadvantaged populations and thereby achieve universal targets. The WASH evidence map is envisioned as a tool for commissioners and researchers to identify existing studies to fill synthesis gaps, as well as helping to prioritise new studies where there are gaps in knowledge. It also supports policymakers and practitioners to navigate the evidence base, including presenting critically appraised findings from existing systematic reviews. Methods This evidence map presents impact evaluations and systematic reviews from the WASH sector, organised according to the types of intervention mechanisms, WASH technologies promoted, and outcomes measured. It is based on a framework of intervention mechanisms (e.g., behaviour change triggering or microloans) and outcomes along the causal pathway, specifically behavioural outcomes (e.g., handwashing and food hygiene practices), ill-health outcomes (e.g., diarrhoeal morbidity and mortality), nutrition and socioeconomic outcomes (e.g., school absenteeism and household income). The map also provides filters to examine the evidence for a particular WASH technology (e.g., latrines), place of use (e.g., home, school or health facility), location (e.g., global region, country, rural and urban) and group (e.g., people living with disability). Systematic searches for published and unpublished literature and trial registries were conducted of studies in low- and middle-income countries (LMICs). Searches were conducted in March 2018, and searches for completed trials were done in May 2020. Coding of information for the map was done by two authors working independently. Impact evaluations were critically appraised according to methods of conduct and reporting. Systematic reviews were critically appraised using a new approach to assess theory-based, mixed-methods evidence synthesis. Results There has been an enormous growth in impact evaluations and systematic reviews of WASH interventions since the International Year of Sanitation, 2008. There are now at least 367 completed or ongoing rigorous impact evaluations in LMICs, nearly three-quarters of which have been conducted since 2008, plus 43 systematic reviews. Studies have been done in 83 LMICs, with a high concentration in Bangladesh, India, and Kenya. WASH sector programming has increasingly shifted in focus from what technology to supply (e.g., a handwashing station or child's potty), to the best way in which to do so to promote demand. Research also covers a broader set of intervention mechanisms. For example, there has been increased interest in behaviour change communication using psychosocial "triggering", such as social marketing and community-led total sanitation. These studies report primarily on behavioural outcomes. With the advent of large-scale funding, in particular by the Bill & Melinda Gates Foundation, there has been a substantial increase in the number of studies on sanitation technologies, particularly latrines. Sustaining behaviour is fundamental for sustaining health and other quality of life improvements. However, few studies have been done of intervention mechanisms for, or measuring outcomes on sustained adoption of latrines to stop open defaecation. There has also been some increase in the number of studies looking at outcomes and interventions that disproportionately affect women and girls, who quite literally carry most of the burden of poor water and sanitation access. However, most studies do not report sex disaggregated outcomes, let alone integrate gender analysis into their framework. Other vulnerable populations are even less addressed; no studies eligible for inclusion in the map were done of interventions targeting, or reporting on outcomes for, people living with disabilities. We were only able to find a single controlled evaluation of WASH interventions in a health care facility, in spite of the importance of WASH in health facilities in global policy debates. The quality of impact evaluations has improved, such as the use of controlled designs as standard, attention to addressing reporting biases, and adequate cluster sample size. However, there remain important concerns about quality of reporting. The quality and usefulness of systematic reviews for policy is also improving, which draw clearer distinctions between intervention mechanisms and synthesise the evidence on outcomes along the causal pathway. Adopting mixed-methods approaches also provides information for programmes on barriers and enablers affecting implementation. Conclusion Ensuring everyone has access to appropriate water, sanitation, and hygiene facilities is one of the most fundamental of challenges for poverty elimination. Researchers and funders need to consider carefully where there is the need for new primary evidence, and new syntheses of that evidence. This study suggests the following priority areas:Impact evaluations incorporating understudied outcomes, such as sustainability and slippage, of WASH provision in understudied places of use, such as health care facilities, and of interventions targeting, or presenting disaggregated data for, vulnerable populations, particularly over the life-course and for people living with a disability;Improved reporting in impact evaluations, including presentation of participant flow diagrams; andSynthesis studies and updates in areas with sufficient existing and planned impact evaluations, such as for diarrhoea mortality, ARIs, WASH in schools and decentralisation. These studies will preferably be conducted as mixed-methods systematic reviews that are able to answer questions about programme targeting, implementation, effectiveness and cost-effectiveness, and compare alternative intervention mechanisms to achieve and sustain outcomes in particular contexts, preferably using network meta-analysis.
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Affiliation(s)
- Hannah Chirgwin
- International Initiative for Impact Evaluation (3ie)London International Development CentreLondonUK
| | | | | | - Hugh Sharma Waddington
- London School of Hygiene and Tropical Medicine and International Initiative for Impact Evaluation (3ie)London International Development CentreLondonUK
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Martcheva M, Tuncer N, Ngonghala CN. Effects of social-distancing on infectious disease dynamics: an evolutionary game theory and economic perspective. JOURNAL OF BIOLOGICAL DYNAMICS 2021; 15:342-366. [PMID: 34182892 DOI: 10.1080/17513758.2021.1946177] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 06/12/2021] [Indexed: 05/20/2023]
Abstract
We propose two models inspired by the COVID-19 pandemic: a coupled disease-human behaviour (or disease-game theoretic), and a coupled disease-human behaviour-economic model, both of which account for the impact of social-distancing on disease control and economic growth. The models exhibit rich dynamical behaviour including multistable equilibria, a backward bifurcation, and sustained bounded periodic oscillations. Analyses of the first model suggests that the disease can be eliminated if everybody practices full social-distancing, but the most likely outcome is some level of disease coupled with some level of social-distancing. The same outcome is observed with the second model when the economy is weaker than the social norms to follow health directives. However, if the economy is stronger, it can support some level of social-distancing that can lead to disease elimination.
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Affiliation(s)
- Maia Martcheva
- Department of Mathematics, University of Florida, Gainesville, FL, USA
| | - Necibe Tuncer
- Department of Mathematics, Florida Atlantic University, Boca Raton, FL, USA
| | - Calistus N Ngonghala
- Department of Mathematics, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
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Park C, Kang H. Assumption-Lean Analysis of Cluster Randomized Trials in Infectious Diseases for Intent-to-Treat Effects and Network Effects. J Am Stat Assoc 2021. [DOI: 10.1080/01621459.2021.1983437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Chan Park
- Department of Statistics, University of Wisconsin–Madison, Madison, WI
| | - Hyunseung Kang
- Department of Statistics, University of Wisconsin–Madison, Madison, WI
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