Quarantine Through History

Identification of dynamical changes of rabies transmission under quarantine: Community-based measures towards rabies elimination

Quarantine has been long used as a public health response to emerging infectious diseases, particularly at the onset of an epidemic when the infected proportion of a population remains identifiable and logistically tractable. In theory, the same logic should apply to low-incidence infections; however, the application and impact of quarantine in low prevalence settings appears less common and lacks a formal analysis. Here, we present a quantitative framework using a series of progressively more biologically realistic models of canine rabies in domestic dogs and from dogs to humans, a suitable example system to characterize dynamical changes under varying levels of dog quarantine. We explicitly incorporate health-seeking behaviour data to inform the modelling of contact-tracing and exclusion of rabies suspect and probable dogs that can be identified through bite-histories of patients presenting at anti-rabies clinics. We find that a temporary quarantine of rabies suspect and probable dogs provides a powerful tool to curtail rabies transmission, especially in settings where optimal vaccination coverage is yet to be achieved, providing a critical stopgap to reduce the number of human and animal deaths due to rabid bites. We conclude that whilst comprehensive measures including sensitive surveillance and large-scale vaccination of dogs will be required to achieve disease elimination and sustained freedom given the persistent risk of rabies re-introductions, quarantine offers a low-cost community driven solution to intersectoral health burden.

Number Needed to Quarantine and Proportion of Prevented Infectious Days by Quarantine: Evaluating the Effectiveness of COVID-19 Contact Tracing

Objectives:

Information on the effectiveness of COVID-19 contact tracing is lacking. We proposed 2 measures for evaluating the effectiveness of contact tracing and applied them in a public health unit in northern Portugal.

Methods:

This retrospective cohort study included the contacts of people with COVID-19 diagnosed July 1–September 15, 2020. We examined 2 measures: (1) number needed to quarantine (NNQ), as the number of quarantine person-days needed to prevent 1 potential infectious person-day; and (2) proportion of prevented infectious days by quarantine (PPID), as the number of potential infectious days prevented by quarantine divided by all infectious days. We assessed these measures by sociodemographic characteristics, types of contacts, and intervention timings (ie, time between diagnosis or symptom onset and intervention). We considered 3 scenarios for infectiousness periods: 10 days before to 10 days after symptom onset, 3 days before to 3 days after symptom onset, and 2 days before to 10 days after symptom onset.

Results:

We found an NNQ of 19.8-41.8 person-days and a PPID of 19.7%-38.2%, depending on the infectiousness period scenario. Effectiveness was higher among cohabitants and symptomatic contacts than among social or asymptomatic contacts. NNQ and PPID changed by intervention timings: the effectiveness of contact tracing decreased with time from diagnosis to quarantine of contacts and with time from symptom onset of the index case to contacts’ quarantine.

Conclusions:

These proposed measures of contact tracing effectiveness of communicable diseases can be important for decision making and prioritizing contact tracing when resources are scarce. They are also useful measures for communication with the general population, policy makers, and clinicians because they are easy to understand and use to assess the impact of health interventions.

The Variation of b-Value of Earthquakes During COVID-19 Lockdowns: Case Studies from the Cascadia Subduction Zone and New Zealand

During the COVID-19 outbreak that took place in early 2020, restrictions on human activities were imposed by government-mandated lockdowns and stay-at-home orders. In this study, we analyse the impact of reduced anthropogenic activities on the detection of seismic events. We hypothesise and show that with reduced background noise levels due to the COVID-19 lockdowns, low-magnitude earthquakes are more easily detectable. We investigate the magnitudes of earthquakes recorded at the seismometers before and after COVID-19 lockdowns for two regions — Cascadia Subduction Zone and New Zealand. Gutenberg–Richter law, which gives a relationship between the number of earthquakes and their magnitudes (b-value), was applied in these two areas. Our results point to an increase in detection of smaller-magnitude earthquakes, as observed by an increased b-value during the COVID-19 period compared to those obtained in the pre-COVID time periods. Previous studies have shown that changes in b-value of an area over a sustained period of time affect the short-time probabilistic risk assessment. The variability of b-value also gives useful insights into the prevailing stress state of the region, crustal heterogeneity, pore pressure and tectonic setting of the area.

The COVID-19 pandemic impacts all domains of quality of life in Egyptians with spinal cord injury: a retrospective longitudinal study

Background and objective

During the COVID-19 pandemic, several aspects of life have been affected. These aspects have been impacted especially in persons with spinal cord injury (SCI). The current study explored the overall effect of the COVID-19 pandemic on quality of life (QOL) domains in persons with SCI as well as evaluated their adherence to WHO-COVID 19-preventive measures.

Design

A retrospective longitudinal study was conducted after asking participants to complete an online validated Arabic version of the WHOQOL-BREF questionnaires including their demographics. The WHOQOL-BREF questionnaires were completed targeting two separate occasions to represent their scores prior to and during the pandemic. Participants were asked to rate their adherence to WHO-COVID-19 preventive measures on a 10-point scale.

Setting and participants

115 participants with complete/ incomplete SCI were recruited via social media and contacted by phone to complete the questionnaires.

Results

Persons with SCI had lower QOL scores during the COVID-19 period compared to their QOL during the pre-COVID-19 period; all QOL domains (Physical Health, Psychological, Social Relationships, and Environment) showed a significant decrease (P < 0.001). Regarding COVID-19 preventative measures, participants were most likely to endorse self-isolation as well as staying home measures and least likely to adhere to hand washing and social distancing measures.

Conclusion

The robustly reduced QOL reported by individuals with SCI during the COVID-19 pandemic highlights the need for rehabilitation and mental health services, particularly administered via telehealth, to buffer the effects of the pandemic. Additionally, psychoeducation and support regarding COVID-19 preventative behaviors in this region would be critical.

Components for Measuring the Efficiency of the Intervention Measures to Support Business, Initiated and Implemented by the Government of Lithuania during the First Lockdown

A lockdown is a set of restrictive actions, in the implementation of which countries face a case of chain reaction: In order to protect human lives and health, the states, due to imbalances in fiscal and monetary policies caused by uncollected planned revenues and unplanned excessive budget expenditures, experience a socio-economic recession. The current paper focuses on the first lockdown implemented in Lithuania to control the spread of COVID-19, which took place from 16 March, 2020 until 16 June, 2020. The main object of the paper is the components that defined the efficiency of the government intervention measures intended to support businesses affected by the first lockdown regime. By generating the mentioned components, we followed the principle of the philosophy of sustainable development: the interdependence of economic, social, environmental, and institutional elements; coherence; and sustainable development. Efficiency is the art of choice, where it is necessary to anticipate the final aim, resulting in maximum benefit from the arrangement of the available limited resources. However, in order to measure the effectiveness of government interventions, we were faced with differences in interpretations of the measurement of the effectiveness of policy decisions. In the course of the research, after analysing secondary data, we identified and, by means of modelling techniques, visualised the main components to estimate the efficiency of the government intervention measures. The theoretical model demonstrated that economic instruments—volume, price, time, transparency, and results—defined the efficiency of their implementation.