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Fulton JP, Trikalinos TA, Popp J, Pollen S, Barclay D, Freeman M, Messick M. Estimating the Effectiveness of COVID-19 Mitigation Policy in Rhode Island. R I Med J (2013) 2024; 107:55-59. [PMID: 38687271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
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2
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Rodriguez NM, Ziolkowski R, Hicks J, Dearing M, Layton J, Balser A, Paton G, Loomis G. Infectious Disease Preparedness for Homeless Populations: Recommendations from a Community-Academic Partnership. Prog Community Health Partnersh 2024; 18:113-119. [PMID: 38661832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
BACKGROUND People experiencing homelessness are at increased risk of infectious disease transmission due to congregate living conditions, barriers to healthcare, and excess burden of underlying chronic disease. OBJECTIVES We are a multisectoral community-academic partnership working to address the intersecting crises of homelessness and health disparities in Tippecanoe County, Indiana. We offer key recommendations for infectious disease preparedness and risk mitigation for homeless populations based on our ongoing community-based participatory research and lessons learned through COVID-19 response and Monkeypox preparations. LESSONS LEARNED Infectious disease preparedness and response in homeless populations requires strong local partnerships; ongoing training and support for staff and volunteers of homeless shelters and service agencies; tailored outreach, education, and communication with people experiencing homelessness; and standardized processes for creating, disseminating, enforcing, and evaluating public health policies in homeless shelters. Consistency and open communication are key to a successful community-academic partnership. CONCLUSIONS Community-academic partnerships are critical to effective infectious disease preparedness in homeless populations. The lessons learned from community-based participatory research with homeless communities and multisectoral partners on the frontline can improve future outbreak and pandemic response for people experiencing homelessness and other vulnerable communities in the United States.
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3
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Khan W, Abubakar A, Brennan RJ, Al Hosani F, Obaid T, Nordstrom A, Friberg P. Preparing for future pandemics in the Eastern Mediterranean region. Lancet 2022; 399:1032-1033. [PMID: 34895469 PMCID: PMC8912930 DOI: 10.1016/s0140-6736(21)02729-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 11/23/2021] [Indexed: 02/07/2023]
Affiliation(s)
- Wasiq Khan
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt.
| | | | | | | | - Thoraya Obaid
- Independent Panel for Pandemic Preparedness and Response, Stockholm, Sweden
| | - Anders Nordstrom
- Independent Panel for Pandemic Preparedness and Response, Stockholm, Sweden
| | - Peter Friberg
- Swedish Institute for Global Health Transformation, Stockholm, Sweden; Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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4
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Hughes JP, Efstratiou A, Komer SR, Baxter LA, Vasiljevic M, Leite AC. The impact of risk perceptions and belief in conspiracy theories on COVID-19 pandemic-related behaviours. PLoS One 2022; 17:e0263716. [PMID: 35134100 PMCID: PMC8824369 DOI: 10.1371/journal.pone.0263716] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 01/25/2022] [Indexed: 12/24/2022] Open
Abstract
Throughout the COVID-19 pandemic, conspiracy theories about the virus spread rapidly, and whilst governments across the globe put in place different restrictions and guidelines to contain the pandemic, these were not universally adhered to. This research examined the association between pandemic related risk perceptions, belief in conspiracy theories, and compliance with COVID-19 public guidelines amongst a UK sample (n = 368). Participants rated their level of concern for a series of potential risks during the pandemic (to the economy, personal health, freedom, media integrity and health risk to others). Participants also rated their level of belief in different conspiracy theories and self-reported their behaviour during the first UK lockdown. Mediational analyses showed that stronger belief in conspiracy theories was associated with perceptions of lower risk to health and higher risk to the economy and freedom, which in turn were associated with lower compliance with COVID-19 related governmental guidelines. Perception of information transparency risks did not mediate the association between belief in conspiracy theories and compliant behaviours. These results highlight the key role that risk perception may play in translating belief in conspiracy theories into low compliance with governmental COVID-19 related guidelines. Our findings suggest new patterns with respect to the relationship between conspiracy theory adherence and salience of different risk perceptions amidst the pandemic, which could have implications for the development of public health messaging and communication interventions.
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Affiliation(s)
- Jack P. Hughes
- Department of Psychology, Durham University, Durham, United Kingdom
- * E-mail:
| | - Alexandros Efstratiou
- Department of Psychology, Durham University, Durham, United Kingdom
- Department of Computer Science, University College London, London, United Kingdom
| | - Sara R. Komer
- Department of Psychology, Durham University, Durham, United Kingdom
| | - Lilli A. Baxter
- Department of Psychology, Durham University, Durham, United Kingdom
| | | | - Ana C. Leite
- Department of Psychology, Durham University, Durham, United Kingdom
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Abstract
Diagnostics have proven to be crucial to the COVID-19 pandemic response. There are three major methods for the detection of SARS-CoV-2 infection and their role has evolved during the course of the pandemic. Molecular tests such as PCR are highly sensitive and specific at detecting viral RNA, and are recommended by WHO for confirming diagnosis in individuals who are symptomatic and for activating public health measures. Antigen rapid detection tests detect viral proteins and, although they are less sensitive than molecular tests, have the advantages of being easier to do, giving a faster time to result, of being lower cost, and able to detect infection in those who are most likely to be at risk of transmitting the virus to others. Antigen rapid detection tests can be used as a public health tool for screening individuals at enhanced risk of infection, to protect people who are clinically vulnerable, to ensure safe travel and the resumption of schooling and social activities, and to enable economic recovery. With vaccine roll-out, antibody tests (which detect the host's response to infection or vaccination) can be useful surveillance tools to inform public policy, but should not be used to provide proof of immunity, as the correlates of protection remain unclear. All three types of COVID-19 test continue to have a crucial role in the transition from pandemic response to pandemic control.
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Affiliation(s)
- Rosanna W Peeling
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK; Medical Microbiology Department, University of Manitoba, Winnipeg, Manitoba, Canada.
| | - David L Heymann
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Yik-Ying Teo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Patricia J Garcia
- School of Public Health, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Global Health, University of Washington, Seattle, WA, USA
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6
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Abstract
Measles is a highly contagious, potentially fatal, but vaccine-preventable disease caused by measles virus. Symptoms include fever, maculopapular rash, and at least one of cough, coryza, or conjunctivitis, although vaccinated individuals can have milder or even no symptoms. Laboratory diagnosis relies largely on the detection of specific IgM antibodies in serum, dried blood spots, or oral fluid, or the detection of viral RNA in throat or nasopharyngeal swabs, urine, or oral fluid. Complications can affect many organs and often include otitis media, laryngotracheobronchitis, pneumonia, stomatitis, and diarrhoea. Neurological complications are uncommon but serious, and can occur during or soon after the acute disease (eg, acute disseminated encephalomyelitis) or months or even years later (eg, measles inclusion body encephalitis and subacute sclerosing panencephalitis). Patient management mainly involves supportive therapy, such as vitamin A supplementation, monitoring for and treatment of secondary bacterial infections with antibiotics, and rehydration in the case of severe diarrhoea. There is no specific antiviral therapy for the treatment of measles, and disease control largely depends on prevention. However, despite the availability of a safe and effective vaccine, measles is still endemic in many countries and causes considerable morbidity and mortality, especially among children in resource-poor settings. The low case numbers reported in 2020, after a worldwide resurgence of measles between 2017 and 2019, have to be interpreted cautiously, owing to the effect of the COVID-19 pandemic on disease surveillance. Disrupted vaccination activities during the pandemic increase the potential for another resurgence of measles in the near future, and effective, timely catch-up vaccination campaigns, strong commitment and leadership, and sufficient resources will be required to mitigate this threat.
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Affiliation(s)
- Judith M Hübschen
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg.
| | - Ionela Gouandjika-Vasilache
- Laboratoire des Virus Entériques et de la Rougeole, Institut Pasteur de Bangui, Bangui, Central African Republic
| | - Julia Dina
- Virology Department, Normandie University, UNICAEN, INSERM U1311 DynaMicURe, Caen University Hospital, Caen, France
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Wallace DD, Urquiza K, Raifman J, Ko M. Putting equity at the heart of the US government's rollout of covid tests and masks. BMJ 2022; 376:o344. [PMID: 35135808 DOI: 10.1136/bmj.o344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
| | | | | | - Michelle Ko
- Division of Health Policy and Management, Department of Public Health Sciences, University of California - Davis, Davis, California, USA
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8
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Ko LK, Tingey L, Ramirez M, Pablo E, Grass R, Larzelere F, Cisneros O, Chu HY, D’Agostino EM. Mobilizing Established School Partnerships to Reach Underserved Children During a Global Pandemic. Pediatrics 2022; 149:e2021054268F. [PMID: 34737178 PMCID: PMC9153654 DOI: 10.1542/peds.2021-054268f] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 11/24/2022] Open
Abstract
The coronavirus disease 2019 pandemic has led to drastic public health measures, including school closures to slow the spread of severe acute respiratory syndrome coronavirus 2 infection. Reopening educational settings by using diagnostic testing approaches in schools can help accelerate the safe return of students and staff to on-site learning by quickly and accurately identifying cases, limiting the spread of severe acute respiratory syndrome coronavirus 2, and ultimately preventing unnecessary school and work absenteeism. Although the National Institutes of Health has identified community partnerships as the foundation for reducing health disparities, we found limited application of a community-based participatory research (CBPR) approach in school engagement. Guided by the CBPR conceptual model, we provide case studies of 2 established and long-standing school-academic partnerships built on CBPR processes and practices that have served as a research infrastructure to reach underserved children and families during the coronavirus disease 2019 pandemic. The process described in this article can serve as an initial platform to continue to build capacity toward increasing health equity.
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Affiliation(s)
- Linda K. Ko
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Lauren Tingey
- Center for American Indian Health, Department of International Health, Johns Hopkins University, Baltimore, Maryland
| | - Magaly Ramirez
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington
| | - Elliott Pablo
- Center for American Indian Health, Department of International Health, Johns Hopkins University, Whiteriver, Arizona
| | - Ryan Grass
- Center for American Indian Health, Department of International Health, Johns Hopkins University, Whiteriver, Arizona
| | - Francene Larzelere
- Center for American Indian Health, Department of International Health, Johns Hopkins University, Whiteriver, Arizona
| | | | - Helen Y. Chu
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington
| | - Emily M. D’Agostino
- Departments of Orthopaedic Surgery and Population Health Sciences, Duke University, Durham, North Carolina
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9
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Dashdorj NJ, Dashdorj ND, Mishra M, Danzig L, Briese T, Lipkin WI, Mishra N. Molecular and Serologic Investigation of the 2021 COVID-19 Case Surge Among Vaccine Recipients in Mongolia. JAMA Netw Open 2022; 5:e2148415. [PMID: 35157057 PMCID: PMC8845004 DOI: 10.1001/jamanetworkopen.2021.48415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This cross-sectional study uses molecular and serologic methods to investigate the 2021 surge in COVID-19 cases among vaccine recipients in Mongolia.
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Affiliation(s)
| | | | - Mitali Mishra
- Center for Infection and Immunity, Columbia University, New York, New York
| | - Lisa Danzig
- Pandefense Advisory, Mill Valley, California
| | - Thomas Briese
- Center for Infection and Immunity, Columbia University, New York, New York
| | - W. Ian Lipkin
- Center for Infection and Immunity, Columbia University, New York, New York
| | - Nischay Mishra
- Center for Infection and Immunity, Columbia University, New York, New York
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Mazzilli R, Zamponi V, Faggiano A. Letter to the editor: how the COVID-19 pandemic has changed outpatient diagnosis in the andrological setting. J Endocrinol Invest 2022; 45:463-464. [PMID: 34506035 PMCID: PMC8429890 DOI: 10.1007/s40618-021-01673-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/01/2021] [Indexed: 11/25/2022]
Affiliation(s)
- R Mazzilli
- Department of Clinical and Molecular Medicine, University of Rome "Sapienza", Sant'Andrea Hospital, Via di Grottarossa 1038, Rome, Italy.
| | - V Zamponi
- Department of Clinical and Molecular Medicine, University of Rome "Sapienza", Sant'Andrea Hospital, Via di Grottarossa 1038, Rome, Italy
| | - A Faggiano
- Department of Clinical and Molecular Medicine, University of Rome "Sapienza", Sant'Andrea Hospital, Via di Grottarossa 1038, Rome, Italy
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D’Agostino EM, Haroz EE, Linde S, Layer M, Green M, Ko LK. School-Academic Partnerships in Support of Safe Return to Schools During the COVID-19 Pandemic. Pediatrics 2022; 149:e2021054268C. [PMID: 34737180 PMCID: PMC9647737 DOI: 10.1542/peds.2021-054268c] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 02/03/2023] Open
Abstract
Safely returning underserved youth to school during the coronavirus disease 2019 (COVID-19) pandemic through diagnostic testing and health education is imperative to mitigate the ongoing negative impact of COVID-19 and reduce health inequalities in underserved communities. The Rapid Acceleration of Diagnostics-Underserved Populations program is a consortium of research projects across the United States funded by the National Institutes of Health to understand the factors associated with the disproportionate burden of the pandemic among underserved populations and to leverage mitigation strategies, including diagnostic testing, with a focus on reducing health disparities. In this article, we provide an overview and introduce the articles from 8 Rapid Acceleration of Diagnostics-Underserved Populations projects featured in the supplement "Navigating a Pandemic in the K-12 Setting: Keeping Our School Communities Safe" published in Pediatrics. These projects funded in the program's first phase focus on COVID-19 diagnostic testing approaches for youth and employees at schools in underserved communities to support safe in-person learning. In the articles comprising the supplement, researchers present barriers and facilitators of the community engagement process necessary to establish school-academic partnerships. These efforts showcase school-based implementation testing strategies during the COVID-19 pandemic but are translatable to tackling other challenges related to reducing health disparities.
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Affiliation(s)
- Emily M. D’Agostino
- Departments of Orthopaedic Surgery
- Population Health Sciences, School of Medicine, Duke University, Durham, North Carolina
| | - Emily E. Haroz
- Johns Hopkins Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Sandra Linde
- Astria Sunnyside Hospital, Sunnyside, Washington
| | - Marcus Layer
- Duke Clinical Research Institute, Durham, North Carolina
| | - Melissa Green
- Center for Health Equity Research, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Linda K. Ko
- University of Washington, Seattle, Washington
- Fred Hutchinson Cancer Research Center, Seattle, Washington
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12
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Sherby MR, Kalb LG, Coller RJ, DeMuri GP, Butteris S, Foxe JJ, Zand MS, Freedman EG, Dewhurst S, Newland JG, Gurnett CA. Supporting COVID-19 School Safety for Children With Disabilities and Medical Complexity. Pediatrics 2022; 149:e2021054268H. [PMID: 34737172 PMCID: PMC8926067 DOI: 10.1542/peds.2021-054268h] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 02/03/2023] Open
Abstract
Children with intellectual and developmental disabilities (IDDs) and children with medical complexity (CMC) have been disproportionally impacted by the coronavirus disease 2019 pandemic, including school closures. Children with IDDs and CMC rely on schools for a vast array of educational, therapeutic, medical, and social needs. However, maintaining safe schools for children with IDDs and CMC during the coronavirus disease 2019 pandemic may be difficult because of the unique challenges of implementing prevention strategies, such as masking, social distancing, and hand hygiene in this high-risk environment. Furthermore, children with IDDs and CMC are at a higher risk of infectious complications and mortality, underscoring the need for effective mitigation strategies. The goal of this report is to describe the implementation of several screening testing models for severe acute respiratory syndrome coronavirus 2 in this high-risk population. By describing these models, we hope to identify generalizable and scalable approaches to facilitate safe school operations for children with IDDs and CMC during the current and future pandemics.
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Affiliation(s)
| | - Luther G. Kalb
- Kennedy Krieger Institute, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | | | | | | | - John J. Foxe
- School of Medicine and Dentistry, University of Rochester, Rochester, New York
| | - Martin S. Zand
- School of Medicine and Dentistry, University of Rochester, Rochester, New York
| | - Edward G. Freedman
- School of Medicine and Dentistry, University of Rochester, Rochester, New York
| | - Stephen Dewhurst
- School of Medicine and Dentistry, University of Rochester, Rochester, New York
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Abstract
School-aged children experienced substantial challenges to health and well-being as a result of school-building closures due to the coronavirus disease 2019 pandemic. In hopes of supporting equitable and safe school reopening for every student across North Carolina (NC) and improving child health, researchers from Duke University and the University at North Carolina at Chapel Hill established the ABC Science Collaborative (ABCs) in July 2020. The ABCs collected data related to in-school severe acute respiratory syndrome coronavirus 2 transmission and adherence to mitigation strategies. These data were presented to NC government officials, including the NC Department of Health and Human Services, the NC Department of Public Instruction, and Democratic and Republican representatives from the NC General Assembly. These data-sharing practices led to the implementation of in-person school legislation in early 2021 in which in-person school access for every student was required, the full-time in-person reopening of NC public schools was supported, and weekly reporting to the ABCs of coronavirus disease 2019 infections from >1 000 000 children and adults was required.
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Affiliation(s)
- Kanecia O. Zimmerman
- Duke Clinical Research Institute and
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
- The ABC Science Collaborative, Durham, North Carolina
| | | | - Daniel K. Benjamin
- Duke Clinical Research Institute and
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
- The ABC Science Collaborative, Durham, North Carolina
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Giardina J, Bilinski A, Fitzpatrick MC, Kendall EA, Linas BP, Salomon J, Ciaranello AL. Model-Estimated Association Between Simulated US Elementary School-Related SARS-CoV-2 Transmission, Mitigation Interventions, and Vaccine Coverage Across Local Incidence Levels. JAMA Netw Open 2022; 5:e2147827. [PMID: 35157056 PMCID: PMC8845023 DOI: 10.1001/jamanetworkopen.2021.47827] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 12/17/2021] [Indexed: 12/20/2022] Open
Abstract
Importance With recent surges in COVID-19 incidence and vaccine authorization for children aged 5 to 11 years, elementary schools face decisions about requirements for masking and other mitigation measures. These decisions require explicit determination of community objectives (eg, acceptable risk level for in-school SARS-CoV-2 transmission) and quantitative estimates of the consequences of changing mitigation measures. Objective To estimate the association between adding or removing in-school mitigation measures (eg, masks) and COVID-19 outcomes within an elementary school community at varying student vaccination and local incidence rates. Design, Setting, and Participants This decision analytic model used an agent-based model to simulate SARS-CoV-2 transmission within a school community, with a simulated population of students, teachers and staff, and their household members (ie, immediate school community). Transmission was evaluated for a range of observed local COVID-19 incidence (0-50 cases per 100 000 residents per day, assuming 33% of all infections detected). The population used in the model reflected the mean size of a US elementary school, including 638 students and 60 educators and staff members in 6 grades with 5 classes per grade. Exposures Variant infectiousness (representing wild-type virus, Alpha variant, and Delta variant), mitigation effectiveness (0%-100% reduction in the in-school secondary attack rate, representing increasingly intensive combinations of mitigations including masking and ventilation), and student vaccination levels were varied. Main Outcomes and Measures The main outcomes were (1) probability of at least 1 in-school transmission per month and (2) mean increase in total infections per month among the immediate school community associated with a reduction in mitigation; multiple decision thresholds were estimated for objectives associated with each outcome. Sensitivity analyses on adult vaccination uptake, vaccination effectiveness, and testing approaches (for selected scenarios) were conducted. Results With student vaccination coverage of 70% or less and moderate assumptions about mitigation effectiveness (eg, masking), mitigation could only be reduced when local case incidence was 14 or fewer cases per 100 000 residents per day to keep the mean additional cases associated with reducing mitigation to 5 or fewer cases per month. To keep the probability of any in-school transmission to less than 50% per month, the local case incidence would have to be 4 or fewer cases per 100 000 residents per day. Conclusions and Relevance In this study, in-school mitigation measures (eg, masks) and student vaccinations were associated with substantial reductions in transmissions and infections, but the level of reduction varied across local incidence. These findings underscore the potential role for responsive plans that deploy mitigation strategies based on local COVID-19 incidence, vaccine uptake, and explicit consideration of community objectives.
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Affiliation(s)
- John Giardina
- Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Alyssa Bilinski
- Department of Health Services, Policy, and Practice, Department of Biostatistics, Brown School of Public Health, Providence, Rhode Island
| | - Meagan C. Fitzpatrick
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore
| | - Emily A. Kendall
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Benjamin P. Linas
- Boston University Schools of Medicine and Public Health, Boston Medical Center, Boston, Massachusetts
| | - Joshua Salomon
- Center for Health Policy and Center for Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, California
| | - Andrea L. Ciaranello
- Division of Infectious Disease and Medical Practice Evaluation Center, Massachusetts General Hospital, Boston
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15
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Rubin EJ, Baden LR, Fineberg HV, Morrissey S. Audio Interview: Crushing the Covid-19 Curve. N Engl J Med 2022; 386:e13. [PMID: 35045234 DOI: 10.1056/nejme2200865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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17
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Puntis JWL. The UK People's Covid Inquiry. Lancet 2022; 399:236. [PMID: 35033219 PMCID: PMC8758181 DOI: 10.1016/s0140-6736(21)02803-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 12/07/2021] [Indexed: 10/27/2022]
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McKay S, Shu’aibu J, Cissé A, Knight A, Abdullahi F, Ibrahim A, Madaki S, Genovezos C, McCoy K, Downs P, Kabore A, Adamu H, Gobir IB, Chaitkin M, Standley CJ. Safely resuming neglected tropical disease control activities during COVID-19: Perspectives from Nigeria and Guinea. PLoS Negl Trop Dis 2021; 15:e0009904. [PMID: 34928945 PMCID: PMC8687572 DOI: 10.1371/journal.pntd.0009904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Since its early spread in early 2020, the disease caused by the novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Coronavirus Disease 2019 (COVID-19) has caused mass disruptions to health services. These have included interruptions to programs that aimed to prevent, control, and eliminate neglected tropical diseases (NTDs). In March 2020, the World Health Organization (WHO) released interim guidelines recommending the temporary cessation of mass drug administration (MDA), community-based surveys, and case detection, while encouraging continuation of morbidity management and vector control where possible. Over the course of the following months, national programs and implementing partners contributed to COVID-19 response efforts, while also beginning to plan for resumption of NTD control activities. To understand the challenges, opportunities, and recommendations for maximizing continuity of disease control during public health emergencies, we sought perspectives from Nigeria and Guinea on the process of restarting NTD control efforts during the COVID-19 pandemic. Through semistructured interviews with individuals involved with NTD control at the local and national levels, we identified key themes and common perspectives between the 2 countries, as well as observations that were specific to each. Overall, interviewees stressed the challenges posed by COVID-19 interruptions, particularly with respect to delays to activities and related knock-on impacts, such as drug expiry and prolonged elimination timelines, as well as concerns related to funding. However, respondents in both countries also highlighted the benefits of a formal risk assessment approach, particularly in terms of encouraging information sharing and increasing coordination and advocacy. Recommendations included ensuring greater availability of historical data to allow better monitoring of how future emergencies affect NTD control progress; continuing to use risk assessment approaches in the future; and identifying mechanisms for sharing lessons learned and innovations between countries as a means of advancing postpandemic health systems and disease control capacity strengthening. Neglected tropical diseases (NTDs) are a group of medically diverse diseases that affect over 1 billion people, predominantly in tropical and subtropical areas, and can cause severe long-term disability and even death. Controlled through mass drug administration (MDA), morbidity management, and/or vector control, NTD programs work closely with communities to identify cases, conduct surveys, and achieve target coverage levels for interventions. The advent of the pandemic of the novel Coronavirus Disease 2019 (COVID-19) in early 2020 led to major disruptions to all facets of life, including health services, with NTD control efforts no exception. Per interim guidelines released by the World Health Organization (WHO) in March 2020, most control activities were halted and only resumed much later in 2020. We sought perspectives from NTD control stakeholders at the subnational and national levels in Guinea and Nigeria regarding the process of planning and executing the resumption of NTD activities to identify challenges, opportunities, and recommendations that might be applicable both to other countries that have experienced disruptions to NTD control efforts during the pandemic and to increase the resilience of NTD programs in the face of future public health emergencies.
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Affiliation(s)
- Stephanie McKay
- Independent Consultant, Hinsdale, Illinois, United States of America
| | | | | | | | | | | | | | | | | | - Philip Downs
- Sightsavers, Durham, North Carolina, United States of America
| | | | - Helen Adamu
- Georgetown Global Health Nigeria, Georgetown University, Abuja, Nigeria
| | - Ibrahim B. Gobir
- Georgetown Global Health Nigeria, Georgetown University, Abuja, Nigeria
| | - Michael Chaitkin
- Independent Consultant, Englewood, Colorado, United States of America
| | - Claire J. Standley
- Center for Global Health Science and Security, Georgetown University, Washington, DC, United States of America
- * E-mail:
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19
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Hopson C. If the NHS falls short on boosters, it won't be for want of trying. BMJ 2021; 375:n3106. [PMID: 34916209 DOI: 10.1136/bmj.n3106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Affiliation(s)
- Gerry McCartney
- College of Social Sciences, University of Glasgow, Glasgow, UK
- Public Health Scotland, Glasgow, UK
| | - Margaret Douglas
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
- Public Health Scotland, Glasgow, UK
| | | | - S Vittal Katikireddi
- Public Health Scotland, Glasgow, UK
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
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21
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Affiliation(s)
- Martin McKee
- London School of Hygiene and Tropical Medicine, London, UK
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22
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Raut AP, Huy NT. Political Races, Religious Congregations, and Inefficacious Measures Amid the Second Wave of COVID-19 in India. Am J Public Health 2021; 111:2100-2102. [PMID: 34878864 PMCID: PMC8667831 DOI: 10.2105/ajph.2021.306544] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Akshay P Raut
- Akshay P. Raut is with the St. George's Hospital, Grant Government Medical College and Sir J. J. Group of Hospitals, Mumbai, India. Nguyen Tien Huy is with the School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Nguyen Tien Huy
- Akshay P. Raut is with the St. George's Hospital, Grant Government Medical College and Sir J. J. Group of Hospitals, Mumbai, India. Nguyen Tien Huy is with the School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
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23
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Doroshenko A, Lee N, MacDonald C, Zelyas N, Asadi L, Kanji JN. Decline of Influenza and Respiratory Viruses With COVID-19 Public Health Measures: Alberta, Canada. Mayo Clin Proc 2021; 96:3042-3052. [PMID: 34863395 PMCID: PMC8450272 DOI: 10.1016/j.mayocp.2021.09.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/13/2021] [Indexed: 12/05/2022]
Abstract
OBJECTIVE To determine the incidence of influenza and noninfluenza respiratory viruses (NIRVs) pre-/post-implementation of public health measures aimed to decrease coronavirus disease 2019 (COVID-19) transmission using population-based surveillance data. We hypothesized that such measures could reduce the burden of respiratory viruses (RVs) transmitting via the same routes. PATIENTS AND METHODS An interrupted time-series analysis of RV surveillance data in Alberta, Canada, from May 2017 to July 2020 was conducted. The burden of influenza and NIRVs before and after intervention initiation at week 11 was compared. The analysis was adjusted for seasonality, overdispersion, and autocorrelation. RESULTS During the study period, an average of 708 and 4056 weekly respiratory multiplex molecular panels were conducted pre-/post-intervention, respectively. We found significant reductions in test positivity rates in the postintervention period for influenza (-94.3%; 95% CI, -93.8 to 97.4%; P<.001) and all NIRVs (-76.5%; 95% CI, -77.3 to -75.8%; P<.001) in the crude model, and -86.2% (95% CI, -91.5 to -77.4%: P<.001) and -75% (95% CI, -79.7 to -69.3%; P<.001), respectively, in the adjusted models. Subanalyses for individual viruses showed significant decreases in respiratory syncytial virus, human metapneumovirus, enterovirus/rhinovirus, and parainfluenza. For non-severe acute respiratory coronavirus 2 human coronaviruses, the decline was not statistically significant after adjustment (-22.3%; 95% CI, -49.3 to +19%, P=.246). CONCLUSION The implementation of COVID-19 public health measures likely resulted in reduced transmission of common RVs. Although drastic lockdowns are unlikely to be required given widespread COVID-19 vaccination, targeted implementation of such measures can lower RV disease burden. Studies to evaluate relative contributions of individual interventions are warranted.
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Key Words
- hcov, human coronavirus
- herv, human entero/rhinovirus
- hmpv, human metapneumovirus
- irr, incident rate ratio
- its, interrupted time series
- nirv, noninfluenza respiratory virus
- pcr, polymerase chain reaction
- piv, parainfluenza virus
- rsv, respiratory syncytial virus
- tpr, test positivity rate
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Affiliation(s)
- Alexander Doroshenko
- Division of Preventive Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Nelson Lee
- Division of Infectious Diseases, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Clayton MacDonald
- Department of Medical Microbiology and Infection Control, Vancouver Coastal Health, Vancouver, British Columbia, Canada
| | - Nathan Zelyas
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada; Public Health Laboratory, Alberta Precision Laboratories, Edmonton, Alberta, Canada
| | - Leyla Asadi
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Jamil N Kanji
- Division of Infectious Diseases, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada; Public Health Laboratory, Alberta Precision Laboratories, Edmonton, Alberta, Canada.
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24
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Harocopos A, Nolan ML, Goldstein GP, Mantha S, O'Neill M, Paone D. Implementing a Methadone Delivery System in New York City in Response to COVID-19. Am J Public Health 2021; 111:2115-2117. [PMID: 34878865 PMCID: PMC8667852 DOI: 10.2105/ajph.2021.306523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2021] [Indexed: 11/04/2022]
Abstract
Opioid agonist medication, including methadone, is considered the first-line treatment for opioid use disorder. Methadone, when taken daily, reduces the risk of fatal overdose; however, overdose risk increases following medication cessation. Amid an overdose epidemic accelerated by the proliferation of fentanyl, ensuring continuity of methadone treatment during the COVID-19 pandemic is a vital public health priority. (Am J Public Health. 2021;111(12):2115-2117. https://doi.org/10.2105/AJPH.2021.306523).
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Affiliation(s)
- Alex Harocopos
- All authors are with the Bureau of Alcohol and Drug Use Prevention, Care, and Treatment, New York City Department of Health and Mental Hygiene, Queens, NY
| | - Michelle L Nolan
- All authors are with the Bureau of Alcohol and Drug Use Prevention, Care, and Treatment, New York City Department of Health and Mental Hygiene, Queens, NY
| | - Gail P Goldstein
- All authors are with the Bureau of Alcohol and Drug Use Prevention, Care, and Treatment, New York City Department of Health and Mental Hygiene, Queens, NY
| | - Shivani Mantha
- All authors are with the Bureau of Alcohol and Drug Use Prevention, Care, and Treatment, New York City Department of Health and Mental Hygiene, Queens, NY
| | - Madeleine O'Neill
- All authors are with the Bureau of Alcohol and Drug Use Prevention, Care, and Treatment, New York City Department of Health and Mental Hygiene, Queens, NY
| | - Denise Paone
- All authors are with the Bureau of Alcohol and Drug Use Prevention, Care, and Treatment, New York City Department of Health and Mental Hygiene, Queens, NY
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25
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Abstract
The purpose of this analytic essay is to contrast the COVID-19 responses in Cuba and the United States, and to understand the differences in outcomes between the 2 nations. With fundamental differences in health systems structure and organization, as well as in political philosophy and culture, it is not surprising that there are major differences in outcomes. The more coordinated, comprehensive response to COVID-19 in Cuba has resulted in significantly better outcomes compared with the United States. Through July 15, 2021, the US cumulative case rate is more than 4 times higher than Cuba's, while the death rate and excess death rate are both approximately 12 times higher in the United States. In addition to the large differences in cumulative case and death rates between United States and Cuba, the COVID-19 pandemic has unmasked serious underlying health inequities in the United States. The vaccine rollout presents its own set of challenges for both countries, and future studies can examine the comparative successes to identify effective strategies for distribution and administration. (Am J Public Health. 2021;111(12):2186-2193. https://doi.org/10.2105/AJPH.2021.306526).
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Affiliation(s)
- Mary Anne Powell
- At the time of the article preparation, Mary Anne Powell was a student at the University of Alabama at Birmingham. Paul C. Erwin is an AJPH associate editor and is with the School of Public Health, University of Alabama at Birmingham. Pedro Mas Bermejo is with the Kourí Tropical Medicine Institute, Havana, Cuba
| | - Paul C Erwin
- At the time of the article preparation, Mary Anne Powell was a student at the University of Alabama at Birmingham. Paul C. Erwin is an AJPH associate editor and is with the School of Public Health, University of Alabama at Birmingham. Pedro Mas Bermejo is with the Kourí Tropical Medicine Institute, Havana, Cuba
| | - Pedro Mas Bermejo
- At the time of the article preparation, Mary Anne Powell was a student at the University of Alabama at Birmingham. Paul C. Erwin is an AJPH associate editor and is with the School of Public Health, University of Alabama at Birmingham. Pedro Mas Bermejo is with the Kourí Tropical Medicine Institute, Havana, Cuba
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Olick RS, Shaw J, Yang YT. Ethical Issues in Mandating COVID-19 Vaccination for Health Care Personnel. Mayo Clin Proc 2021; 96:2958-2962. [PMID: 34863393 PMCID: PMC8633920 DOI: 10.1016/j.mayocp.2021.10.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/02/2021] [Accepted: 10/26/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Robert S Olick
- Center for Bioethics and Humanities; Department of Internal Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC.
| | - Jana Shaw
- Department of Pediatrics, State University of New York Upstate Medical University, Syracuse
| | - Y Tony Yang
- Center for Health Policy and Media Engagement, George Washington University, Washington, DC
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Abstract
Bin Du and colleagues explore the Wuhan response to managing critically ill patients in a novel disease pandemic, and lessons learnt for dealing with future pandemics
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Affiliation(s)
- Bin Du
- State Key Laboratory of Rare, Complex and Critical Diseases, Medical Intensive Care Unit, Peking Union Medical College Hospital, Beijing 100730, China
| | - Chunting Wang
- Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Mervyn Singer
- Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, London, UK
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Paulose-Ram R, Graber JE, Woodwell D, Ahluwalia N. The National Health and Nutrition Examination Survey (NHANES), 2021-2022: Adapting Data Collection in a COVID-19 Environment. Am J Public Health 2021; 111:2149-2156. [PMID: 34878854 PMCID: PMC8667826 DOI: 10.2105/ajph.2021.306517] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2021] [Indexed: 11/04/2022]
Abstract
The National Health and Nutrition Examination Survey (NHANES) is a unique source of national data on the health and nutritional status of the US population, collecting data through interviews, standard exams, and biospecimen collection. Because of the COVID-19 pandemic, NHANES data collection was suspended, with more than a year gap in data collection. NHANES resumed operations in 2021 with the NHANES 2021-2022 survey, which will monitor the health and nutritional status of the nation while adding to the knowledge of COVID-19 in the US population. This article describes the reshaping of the NHANES program and, specifically, the planning of NHANES 2021-2022 for data collection during the COVID-19 pandemic. Details are provided on how NHANES transformed its participant recruitment and data collection plans at home and at the mobile examination center to safely collect data in a COVID-19 environment. The potential implications for data users are also discussed. (Am J Public Health. 2021;111(12):2149-2156. https://doi.org/10.2105/AJPH.2021.306517).
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Affiliation(s)
- Ryne Paulose-Ram
- >Ryne Paulose-Ram, Jessica E. Graber, David Woodwell, and Namanjeet Ahluwalia are with the Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD
| | - Jessica E Graber
- >Ryne Paulose-Ram, Jessica E. Graber, David Woodwell, and Namanjeet Ahluwalia are with the Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD
| | - David Woodwell
- >Ryne Paulose-Ram, Jessica E. Graber, David Woodwell, and Namanjeet Ahluwalia are with the Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD
| | - Namanjeet Ahluwalia
- >Ryne Paulose-Ram, Jessica E. Graber, David Woodwell, and Namanjeet Ahluwalia are with the Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD
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29
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Watterson A. Independent SAGE can be judged on its successes just as the UK government can be judged on its failures. BMJ 2021; 375:n2797. [PMID: 34789486 DOI: 10.1136/bmj.n2797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Andrew Watterson
- Faculty of Health Sciences, University of Stirling, Stirling, UK
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30
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Bhutta ZA, Mitra A, Salman A, Akbari F, Dalil S, Jehan F, Chowdhury M, Jayasinghe S, Menon P, Nundy S, Qadri F, Islam MT, Gautam K. Conflict, extremism, resilience and peace in South Asia; can covid-19 provide a bridge for peace and rapprochement? BMJ 2021; 375:e067384. [PMID: 34782331 PMCID: PMC8591480 DOI: 10.1136/bmj-2021-067384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Zulfiqar A Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada
- Institute for Global Health and Development, Aga Khan University, South-central Asia, East Africa, and UK
| | - Arun Mitra
- Indian Doctors for Peace & Development, Ludhiana, Punjab, India
| | - Afsah Salman
- Trust for Vaccines and Immunizations, Karachi, Pakistan
| | | | - Suraya Dalil
- Special Programme on Primary Health Care, World Health Organization, Geneva
| | - Fyezah Jehan
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | | | | | - Purnima Menon
- International Food Policy Research Institute, New Dehli, India
| | - Samiran Nundy
- Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India
| | - Firdausi Qadri
- Enteric and Respiratory Infections, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Md Taufiqul Islam
- Enteric and Respiratory Infections, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
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31
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Sonabend R, Whittles LK, Imai N, Perez-Guzman PN, Knock ES, Rawson T, Gaythorpe KAM, Djaafara BA, Hinsley W, FitzJohn RG, Lees JA, Kanapram DT, Volz EM, Ghani AC, Ferguson NM, Baguelin M, Cori A. Non-pharmaceutical interventions, vaccination, and the SARS-CoV-2 delta variant in England: a mathematical modelling study. Lancet 2021; 398:1825-1835. [PMID: 34717829 PMCID: PMC8550916 DOI: 10.1016/s0140-6736(21)02276-5] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/28/2021] [Accepted: 10/07/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND England's COVID-19 roadmap out of lockdown policy set out the timeline and conditions for the stepwise lifting of non-pharmaceutical interventions (NPIs) as vaccination roll-out continued, with step one starting on March 8, 2021. In this study, we assess the roadmap, the impact of the delta (B.1.617.2) variant of SARS-CoV-2, and potential future epidemic trajectories. METHODS This mathematical modelling study was done to assess the UK Government's four-step process to easing lockdown restrictions in England, UK. We extended a previously described model of SARS-CoV-2 transmission to incorporate vaccination and multi-strain dynamics to explicitly capture the emergence of the delta variant. We calibrated the model to English surveillance data, including hospital admissions, hospital occupancy, seroprevalence data, and population-level PCR testing data using a Bayesian evidence synthesis framework, then modelled the potential trajectory of the epidemic for a range of different schedules for relaxing NPIs. We estimated the resulting number of daily infections and hospital admissions, and daily and cumulative deaths. Three scenarios spanning a range of optimistic to pessimistic vaccine effectiveness, waning natural immunity, and cross-protection from previous infections were investigated. We also considered three levels of mixing after the lifting of restrictions. FINDINGS The roadmap policy was successful in offsetting the increased transmission resulting from lifting NPIs starting on March 8, 2021, with increasing population immunity through vaccination. However, because of the emergence of the delta variant, with an estimated transmission advantage of 76% (95% credible interval [95% CrI] 69-83) over alpha, fully lifting NPIs on June 21, 2021, as originally planned might have led to 3900 (95% CrI 1500-5700) peak daily hospital admissions under our central parameter scenario. Delaying until July 19, 2021, reduced peak hospital admissions by three fold to 1400 (95% CrI 700-1700) per day. There was substantial uncertainty in the epidemic trajectory, with particular sensitivity to the transmissibility of delta, level of mixing, and estimates of vaccine effectiveness. INTERPRETATION Our findings show that the risk of a large wave of COVID-19 hospital admissions resulting from lifting NPIs can be substantially mitigated if the timing of NPI relaxation is carefully balanced against vaccination coverage. However, with the delta variant, it might not be possible to fully lift NPIs without a third wave of hospital admissions and deaths, even if vaccination coverage is high. Variants of concern, their transmissibility, vaccine uptake, and vaccine effectiveness must be carefully monitored as countries relax pandemic control measures. FUNDING National Institute for Health Research, UK Medical Research Council, Wellcome Trust, and UK Foreign, Commonwealth and Development Office.
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Affiliation(s)
- Raphael Sonabend
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK
| | - Lilith K Whittles
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK; National Institute for Health Research Health Protection Research Unit in Modelling Methodology, Imperial College London, Public Health England, London School of Hygiene & Tropical Medicine, London, UK; Modelling and Economics Unit, National Infection Service, Public Health England, London, UK
| | - Natsuko Imai
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK
| | - Pablo N Perez-Guzman
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK
| | - Edward S Knock
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK; National Institute for Health Research Health Protection Research Unit in Modelling Methodology, Imperial College London, Public Health England, London School of Hygiene & Tropical Medicine, London, UK
| | - Thomas Rawson
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK
| | - Katy A M Gaythorpe
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK
| | - Bimandra A Djaafara
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK
| | - Wes Hinsley
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK
| | - Richard G FitzJohn
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK
| | - John A Lees
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK
| | - Divya Thekke Kanapram
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK
| | - Erik M Volz
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK
| | - Azra C Ghani
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK
| | - Neil M Ferguson
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK; National Institute for Health Research Health Protection Research Unit in Modelling Methodology, Imperial College London, Public Health England, London School of Hygiene & Tropical Medicine, London, UK.
| | - Marc Baguelin
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK; National Institute for Health Research Health Protection Research Unit in Modelling Methodology, Imperial College London, Public Health England, London School of Hygiene & Tropical Medicine, London, UK; Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Anne Cori
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK; National Institute for Health Research Health Protection Research Unit in Modelling Methodology, Imperial College London, Public Health England, London School of Hygiene & Tropical Medicine, London, UK.
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Abstract
Pandemic preparedness is a key function of any health care facility. Activities pertaining to pandemic preparedness should be developed and maintained within a broader emergency management plan. The use of a Hospital Incident Command System can centralize coordination of the response and facilitate internal and external communication. This review addresses several components of pandemic preparedness, including incident management, health care personnel safety, strategies to support ongoing clinical activities, and organizational communication during a pandemic. Preparations addressing potential ethical challenges and the psychological impact associated with pandemic response are also reviewed.
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Affiliation(s)
- Casey E Godshall
- Department of Medicine, University of Connecticut School of Medicine, Farmington, CT, USA
| | - David B Banach
- Department of Medicine, University of Connecticut School of Medicine, Farmington, CT, USA.
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33
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Abstract
Coronavirus disease 2019 (COVID-19) affects all components of the respiratory system, including the neuromuscular breathing apparatus, conducting and respiratory airways, pulmonary vascular endothelium, and pulmonary blood flow. In contrast to other respiratory viruses, children have less severe symptoms when infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A minority of children experience a post-infectious inflammatory syndrome, the pathology and long-term outcomes of which are poorly understood. The reason for the lower burden of symptomatic disease in children is not yet clear, but several pathophysiological characteristics are postulated. The SARS-CoV-2 pandemic has brought distinct challenges to the care of children globally. Proper recommendations have been proposed for a range of non-asthmatic respiratory disorders in children, including primary ciliary dyskinesia and cystic fibrosis. These recommendations involve the continuation of the treatment during this period and ways to maintain stability. School closures, loss of follow-up visit attendance, and loss of other protective systems for children are the indirect outcomes of measures to mitigate the COVID-19 pandemic. Moreover, COVID-19 has reshaped the delivery of respiratory care in children, with non-urgent and elective procedures being postponed, and distancing imperatives have led to rapid scaling of telemedicine. The pandemic has seen an unprecedented reorientation in clinical trial research towards COVID-19 and a disruption in other trials worldwide, which will have long-lasting effects on medical science. In this narrative review, we sought to outline the most recent findings on the direct and indirect effects of SARS-CoV-2 pandemic on pediatric respiratory chronic diseases other than asthma, by critically revising the most recent literature on the subject.
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Affiliation(s)
- Maria Di Cicco
- Allergology Section, Paediatrics Unit, Pisa University Hospital, Via Roma n. 67, 56126, Pisa, Italy.
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma n. 55, 56126, Pisa, Italy.
| | - Maria Giulia Tozzi
- Allergology Section, Paediatrics Unit, Pisa University Hospital, Via Roma n. 67, 56126, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma n. 55, 56126, Pisa, Italy
| | - Vincenzo Ragazzo
- Paediatrics and Neonatology Division, Women's and Children's Health Department, Versilia Hospital, Via Aurelia n. 335, Lido Di Camaioree, Italy, 55049
| | - Diego Peroni
- Allergology Section, Paediatrics Unit, Pisa University Hospital, Via Roma n. 67, 56126, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma n. 55, 56126, Pisa, Italy
| | - Ahmad Kantar
- Paediatric Asthma and Cough Centre, Istituti Ospedalieri Bergamaschi - Gruppo Ospedaliero San Donato, via Forlanini n. 15, 24036, Ponte S. Pietro - Bergamo, Italy
- Vita-Salute San Raffaele University, Via Olgettina n. 58, 20132, Milan, Italy
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34
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Di Luise E, Magni PA. Interim recommendations for the management of forensic investigation during the COVID-19 pandemic: An Italian perspective. Sci Justice 2021; 61:735-742. [PMID: 34802647 PMCID: PMC8375245 DOI: 10.1016/j.scijus.2021.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 07/04/2021] [Accepted: 08/17/2021] [Indexed: 12/14/2022]
Abstract
The Coronavirus disease 2019 (COVID-19) is spreading around the world, representing a global pandemic. In this context, governments from around the world suspended almost all education, industry and business activities, alongside restricting the movement of people. Nevertheless, during this period, the activity of the law enforcement and forensic investigators never stopped. At present, guidelines regarding forensic autopsies of SARS-CoV-2 virus-positive cases and the handling of potentially infected biological samples are available in literature. However, less attention has been given to the development of specific adjustments to the existing crime scene investigation protocols and procedures for this exceptional time. This manuscript aims to share the methods and strategies adopted for the investigation of high priority criminal cases during the pandemic. Furthermore, other pandemic-related processes are critically explored, in order to propose adjustments for any forensic services to be prepared to face similar challenges in the future. The overall goal of this manuscript is to provide a summary of the main measures and the procedures developed to make the operations possible, while safeguarding the technicians in the field and the activity in the forensic laboratory. In order to minimize the risk of infection for personnel, adjustments to the standard practice have been proposed for each of the different phases of crime scene management, i.e. CSI call policy, equipment preparation, working groups, procedure at the scene, chain of custody and analyses of the evidence at the forensic lab. As this is a current study, based on limited cases and limited sources in the literature, changes and updates to the indications provided in this paper may be needed in the near future, according to new virological data epidemiological trends.
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Affiliation(s)
- Enrico Di Luise
- Commander of Sezione Intervento Operativo (S.I.O.) - Arma Carabinieri, Reparto Carabinieri Investigazioni Scientifiche (R.I.S.), di Messina, Italy; Laboratory of Forensic Biology, Arma Carabinieri, Reparto Carabinieri Investigazioni Scientifiche (R.I.S.), di Messina, Italy
| | - Paola A Magni
- Discipline of Medical, Molecular & Forensic Sciences, Murdoch University, 90 South Street, Murdoch, Western Australia 6150, Australia; Murdoch University Singapore, King's Centre, 390 Havelock Road, Singapore 169662, Singapore.
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Chinnaswamy S. SARS-CoV-2 infection in India bucks the trend: Trained innate immunity? Am J Hum Biol 2021; 33:e23504. [PMID: 32965717 PMCID: PMC7536963 DOI: 10.1002/ajhb.23504] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 07/26/2020] [Accepted: 08/24/2020] [Indexed: 01/08/2023] Open
Abstract
SARS-CoV-2, the causative agent of COVID-19 pandemic caught the world unawares by its sudden onset in early 2020. Memories of the 1918 Spanish Flu were rekindled raising extreme fear for the virus, but in essence, it was the host and not the virus, which was deciding the outcome of the infection. Age, gender, and preexisting conditions played critical roles in shaping COVID-19 outcome. People of lower socioeconomic strata were disproportionately affected in industrialized countries such as the United States. India, a developing country with more than 1.3 billion population, a large proportion of it being underprivileged and with substandard public health provider infrastructure, feared for the worst outcome given the sheer size and density of its population. Six months into the pandemic, a comparison of COVID-19 morbidity and mortality data between India, the United States, and several European countries, reveal interesting trends. While most developed countries show curves expected for a fast-spreading respiratory virus, India seems to have a slower trajectory. As a consequence, India may have gained on two fronts: the spread of the infection is unusually prolonged, thus leading to a curve that is "naturally flattened"; concomitantly the mortality rate, which is a reflection of the severity of the disease has been relatively low. I hypothesize that trained innate immunity, a new concept in immunology, may be the phenomenon behind this. Biocultural, socioecological, and socioeconomic determinants seem to be influencing the outcome of COVID-19 in different regions/countries of the world.
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Affiliation(s)
- Sreedhar Chinnaswamy
- Infectious Disease GeneticsNational Institute of Biomedical GenomicsKalyaniIndia
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Abstract
BACKGROUND The Ending the HIV Epidemic (EHE) initiative aims to reduce incident HIV infections by 90% over a span of 10 years. The intensity of interventions needed to achieve this for local epidemics is unclear. OBJECTIVE To estimate the effect of HIV interventions at the city level. DESIGN A compartmental model of city-level HIV transmission stratified by age, race, sex, and HIV risk factor was developed and calibrated. SETTING 32 priority metropolitan statistical areas (MSAs). PATIENTS Simulated populations in each MSA. INTERVENTION Combinations of HIV testing and preexposure prophylaxis (PrEP) coverage among those at risk for HIV, plus viral suppression in persons with diagnosed HIV infection. MEASUREMENTS The primary outcome was the projected reduction in incident cases from 2020 to 2030. RESULTS Absent intervention, HIV incidence was projected to decrease by 19% across all 32 MSAs. Modest increases in testing (1.25-fold per year), PrEP coverage (5 percentage points), and viral suppression (10 percentage points) across the population could achieve reductions of 34% to 67% by 2030. Twenty-five percent PrEP coverage, testing twice a year on average, and 90% viral suppression among young Black and Hispanic men who have sex with men (MSM) achieved similar reductions (13% to 68%). Including all MSM and persons who inject drugs could reduce incidence by 48% to 90%. Thirteen of 32 MSAs could achieve greater than 90% reductions in HIV incidence with large-scale interventions that include heterosexuals. A web application with location-specific results is publicly available (www.jheem.org). LIMITATION The COVID-19 pandemic was not represented. CONCLUSION Large reductions in HIV incidence are achievable with substantial investment, but the EHE goals will be difficult to achieve in most locations. An interactive model that can help policymakers maximize the effect in their local environments is presented. PRIMARY FUNDING SOURCE National Institutes of Health.
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Affiliation(s)
- Anthony Todd Fojo
- Johns Hopkins University School of Medicine, Baltimore, Maryland (A.T.F., M.S.)
| | - Melissa Schnure
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (M.S., P.K., D.W.D.)
| | - Parastu Kasaie
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (M.S., P.K., D.W.D.)
| | - David W Dowdy
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (M.S., P.K., D.W.D.)
| | - Maunank Shah
- Johns Hopkins University School of Medicine, Baltimore, Maryland (A.T.F., M.S.)
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Dong Y, Ding S, Zhang J, Liu Y. Epidemiology of COVID-19 in Jiangxi, China: A retrospective observational study. Medicine (Baltimore) 2021; 100:e27685. [PMID: 34713866 PMCID: PMC8556035 DOI: 10.1097/md.0000000000027685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 09/26/2021] [Accepted: 10/13/2021] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT To analyze the epidemiological characteristics of coronavirus disease 2019 (COVID-19) in Jiangxi Province, China, from January 21 to April 9, 2020.COVID-19 epidemic information was obtained from the official websites of the Jiangxi Provincial Health Committee, Hubei Provincial Health Committee, and National Health Commission of the People's Republic of China. ArcGIS 10.0 was used to draw a map of the spatial distribution of the cases.On January 21, 2020, the first COVID-19 confirmed case in Jiangxi was reported. By January 27, COVID-19 had spread rapidly to all cities in Jiangxi. The outbreak peaked on February 3, with a daily incidence of 85 cases. The last indigenous case reported on February 27. From January 21 to April 9, a total of 937 confirmed cases of COVID-19 were reported, with a cumulative incidence of 2.02/100,000. Of those, 936 patients (99.89%) were cured, and 1 (0.11%) died due to COVID-19. The COVID-19 epidemic trend in Jiangxi was basically consistent with the national epidemic trend (except Hubei). Throughout the epidemic prevention and control phase, Jiangxi province has taken targeted prevention and control measures based on the severity of the spread of COVID-19.The COVID-19 epidemic in Jiangxi was widespread and developed rapidly. In less than 1 month, the epidemic situation was effectively controlled, and the epidemic situation shifted to a low-level distribution state. All these proved that the COVID-19 prevention and control strategies and measures adopted by Jiangxi Province were right, positive and effective.
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Affiliation(s)
- Yonghai Dong
- Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, Jiangxi, China
| | - Sheng Ding
- Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, Jiangxi, China
| | - Jingyu Zhang
- Clinical Laboratory, the First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yun Liu
- Department of Imaging, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, Jiangxi, China
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Affiliation(s)
- Deepti Gurdasani
- William Harvey Research Institute, Queen Mary University of London, London, UK
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Martin McKee
- William Harvey Research Institute, Queen Mary University of London, London, UK
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
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Rajput A, Sajid M, Tanvi, Shekhar C, Aggarwal R. Optimal control strategies on COVID-19 infection to bolster the efficacy of vaccination in India. Sci Rep 2021; 11:20124. [PMID: 34635703 PMCID: PMC8505443 DOI: 10.1038/s41598-021-99088-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 09/20/2021] [Indexed: 12/24/2022] Open
Abstract
The Novel Coronavirus which emerged in India on January/30/2020 has become a catastrophe to the country on the basis of health and economy. Due to rapid variations in the transmission of COVID-19, an accurate prediction to determine the long term effects is infeasible. This paper has introduced a nonlinear mathematical model to interpret the transmission dynamics of COVID-19 infection along with providing vaccination in the precedence. To minimize the level of infection and treatment burden, the optimal control strategies are carried out by using the Pontryagin's Maximum Principle. The data validation has been done by correlating the estimated number of infectives with the real data of India for the month of March/2021. Corresponding to the model, the basic reproduction number [Formula: see text] is introduced to understand the transmission dynamics of COVID-19. To justify the significance of parameters we determined the sensitivity analysis of [Formula: see text] using the parameters value. In the numerical simulations, we concluded that reducing [Formula: see text] below unity is not sufficient enough to eradicate the COVID-19 disease and thus, it is required to increase the vaccination rate and its efficacy by motivating individuals to take precautionary measures.
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Affiliation(s)
- Ashutosh Rajput
- Department of Mathematics, Deshbandhu College, University of Delhi, New Delhi, 110019, India
- DBC i4 Centre, Deshbandhu College, University of Delhi, New Delhi, 110019, India
| | - Mohammad Sajid
- Department of Mechanical Engineering, College of Engineering, Qassim University, Buraidah, Al Qassim, Saudi Arabia
| | - Tanvi
- Department of Mathematics, Deshbandhu College, University of Delhi, New Delhi, 110019, India
- DBC i4 Centre, Deshbandhu College, University of Delhi, New Delhi, 110019, India
| | - Chandra Shekhar
- Department of Mathematics, Deshbandhu College, University of Delhi, New Delhi, 110019, India
- DBC i4 Centre, Deshbandhu College, University of Delhi, New Delhi, 110019, India
| | - Rajiv Aggarwal
- Department of Mathematics, Deshbandhu College, University of Delhi, New Delhi, 110019, India.
- DBC i4 Centre, Deshbandhu College, University of Delhi, New Delhi, 110019, India.
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Abstract
Beginning from the first reports of COVID-19 out of China, this article provides a commentary on the actions taken by the Government of New Zealand in terms of nine themes-a national response with an elimination goal, speed, and comprehensiveness of the initial response; an evidence-based, science-led approach, prioritised on protecting lives; effective communication; leadership style which appealed to collective responsibility and attempted to de-politicise the Government's response to the virus; flexibility of response characterised by 'learning as you go'; oversight of coercive state powers, including a pragmatic response which attempted to defuse conflict and reserved use of 'hard power' to a last resort; deployment of public health interventions, and health system adaptations; the impact on Māori and marginalised communities; and economic protection and stimulus-to identify factors that might help explain why New Zealand's pandemic response was successful and those which could have been managed better. The partially successful legal challenge brought to the four-and-a half week lockdown, the most stringent in the world, in Borrowdale v Director-General of Health, is also considered.
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Nakamura M. Consideration about the society after the COVID-19. Ind Health 2021; 59:293-297. [PMID: 34421101 PMCID: PMC8516626 DOI: 10.2486/indhealth.2021-0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 05/14/2021] [Indexed: 06/13/2023]
Abstract
This paper reviews three viewpoints regarding the society after the COVID-19 infection on the concept of safety management. The first is the relationship between With COVID-19 and a zero risk. As a result of coexistence with COVID-19 for more than one year, the Japanese society thought that a zero risk is difficult to accomplish, and some risks will be accepted to maintain social activities. This leads a change in a way of thinking from zero risk to risk-based safety management. The second is the change in the way of working. As a result of having experienced remote work forcibly, it will become the hybrid model that incorporated remote work in a conventional method. Personnel evaluation changes from the seniority system to the job evaluation type, and each person's professional ability will be more focused on. The third is the review of the Japanese society system. In Japan, although the infection level was controlled to some extent by the groupism of the self-restraint of actions by mutual monitoring, there is a limit of managing based on groupism. Moreover, as seen in the delay of vaccine development and the medical care collapse, these problems should be improved by changing Japanese society system.
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Affiliation(s)
- Masayoshi Nakamura
- Department of Innovation Science/Technology and Innovation Management, Tokyo Institute of Technology, Japan
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Wu CH, Chou YC, Lin FH, Hsieh CJ, Wu DC, Peng CK, Yu CP. Epidemiological features of domestic and imported cases with COVID-19 between January 2020 and March 2021 in Taiwan. Medicine (Baltimore) 2021; 100:e27360. [PMID: 34596146 PMCID: PMC8483820 DOI: 10.1097/md.0000000000027360] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 09/09/2021] [Indexed: 01/05/2023] Open
Abstract
Coronavirus disease-2019 (COVID-19) is a global pandemic affecting numerous countries around the world. This study elaborates Taiwan's epidemiological characteristics from the 2020 to 2021 COVID-19 pandemic from human, temporal, and geographical dimensions. Big data for cases were obtained from a public database from the Taiwan Centers for Disease Control (CDC) in April 2021. The data were analyzed and used to compare differences, correlations, and trends for human, temporal, and geographical characteristics for imported and domestic COVID-19 cases. During the study period, 1030 cases were confirmed and the mortality rate of 1.0%. The epidemiological features indicated that most cases (953/1030, 92.5%) were imported. A comparison of the domestic confirmed and imported cases revealed the following findings: No significant difference of COVID-19 between males and females for sex was observed; For age, the risk of domestic transmission was significantly lower for 20 to 29 years old, higher for 50 to 59 years old, and >60 years old with odds ratios (ORs) (P value < .05) of 0.36, 3.37, and 2.50, respectively; For the month of infection, the ORs (P value < .05) of domestic confirmed cases during January and February 2020 were 22.428; and in terms of area of residence, the ORs (P value < .05) for domestic confirmed cases in northern and southern Taiwan were 4.473 and 0.033, respectively. Thus, the increase in domestic cases may have been caused by international travelers transmitting the virus in March 2020 and December 2020, respectively. Taiwan has been implementing effective screening and quarantine measures at airports. Moreover, Taiwan has implemented and maintained stringent interventions such as large-scale epidemiological investigation, rapid diagnosis, wearing masks, washing hands frequently, safe social distancing, and prompt clinical classifications for severe patients who were given appropriate medical measures. This is the first report comparing imported and domestic cases of COVID-19 from surveillance data from the Taiwan Centers for Disease Control during January 2020 and March 2021. It illustrates that individuals infected during overseas travel are the main risk factors for the spread of COVID-19 in Taiwan. The study also highlights the importance of longitudinal and geographically extended studies in understanding the implications of COVID-19 transmission for Taiwan's population.
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Affiliation(s)
- Chun-Han Wu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Ching Chou
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Fu-Huang Lin
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Jeng Hsieh
- Department of Health Care Administration, Asia Eastern University of Science and Technology, New Taipei City, Taiwan
| | - Ding-Chung Wu
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Chung-Kan Peng
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Peng Yu
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
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Affiliation(s)
- Lori Tremmel Freeman
- Lori Tremmel Freeman is chief executive officer at National Association of County and City Health Officials, Washington, DC
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Ajumobi O, Afolabi RF, Adewole A, Balogun MS, Nguku P, Ajayi IO. What do malaria program officers want to learn? A survey of perspectives on a proposed malaria short course in Nigeria. PLoS One 2021; 16:e0257890. [PMID: 34587210 PMCID: PMC8480891 DOI: 10.1371/journal.pone.0257890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 09/14/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In disease control, the program officers are vital to the successful implementation of control strategies. However, poor knowledge of the disease and its control, staff attrition, and lack of intentional training for new staff can lead to under-performance and ineffectiveness of interventions. Thus, the Nigeria Field Epidemiology and Laboratory Training Program, in collaboration with National Malaria Elimination Program, planned a malaria short course (MSC) to strengthen the capacity of current program managers and incoming staff. To guide the development of the curriculum for the MSC, we conducted a needs assessment survey to ascertain the perceived usefulness of the MSC, the priority rating of MSC thematic domains and associated factors. METHODS Overall, 384 purposively selected respondents across ten states and the Federal Capital Territory in Nigeria were interviewed. These comprised malaria and non-malaria control program staff at state, local government area (LGA) and ward levels. We administered a structured questionnaire to elicit information on socio-demographics, training needs, priority malaria thematic domains, perceived course usefulness and willingness of ministries/organizations to release staff to attend the MSC. Data were analyzed using descriptive and inferential statistics at p<0.05. RESULTS Mean age was 43.9 (standard deviation: 7.6 years), 172 (44.8%) were females. Of the 384 respondents, 181 (47.1%), 144 (37.5%) and 59 (15.4%) were at the ward, LGA and state levels, respectively. Seventy-two (18.8%) had never worked in malaria control program. Majority (98.7%, n = 379) reported the need for further training, 382 (99.5%) opined that the course would be useful, and all affirmed their employers' willingness towards their participation at the training. Respondents rated high the domains of basic malariology, malaria treatment, malaria prevention, surveillance/data management, use of computers, leadership skills, program management and basic statistics. Predictors of malaria topical domains' high rating were gender (odds ratio (OR) = 6.77; 95% CI:3.55-12.93) and educational qualifications (OR = 0.48; 95% CI:0.26-0.89). CONCLUSIONS A malaria short course is a necessity and appropriate for program officers at different levels of health administration in Nigeria to achieve malaria elimination, taking into consideration the challenges of human resource retention. The outcome of this study should inform the curriculum and the delivery of the MSC.
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Affiliation(s)
- Olufemi Ajumobi
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
- School of Public Health, University of Nevada, Reno, Nevada, United States of America
| | - Rotimi Felix Afolabi
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Population and Health Research Entity, North-West University, Mmabatho, South Africa
| | - Adefisoye Adewole
- African Field Epidemiology Network Nigeria Country Office, Abuja, Nigeria
| | | | - Patrick Nguku
- African Field Epidemiology Network Nigeria Country Office, Abuja, Nigeria
| | - IkeOluwapo O. Ajayi
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Strangio A, Leo I, Spaccarotella CAM, Barillà F, Basso C, Calabrò MP, Curcio A, Filardi PP, Mancone M, Mercuro G, Muscoli S, Nodari S, Pedrinelli R, Romeo F, Sinagra G, Indolfi C. Effects of the COVID-19 pandemic on the formation of fellows in training in cardiology. J Cardiovasc Med (Hagerstown) 2021; 22:711-715. [PMID: 34009835 DOI: 10.2459/jcm.0000000000001185] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
CoronaVIrus Disease-19 (COVID-19) had a huge impact on human health and economy. However, to this date, the effects of the pandemic on the training of young cardiologists are only partially known. To assess the consequences of the pandemic on the education of the cardiologists in training, we performed a 23-item national survey that has been delivered to 1443 Italian cardiologists in training, registered in the database of the Italian Society of Cardiology (SIC). Six hundred and thirty-three cardiologists in training participated in the survey. Ninety-five percent of the respondents affirmed that the training programme has been somewhat stopped or greatly jeopardized by the pandemic. For 61% of the fellows in training (FITs), the pandemic had a negative effect on their education. Moreover, 59% of the respondents believe that they would not be able to fill the gap gained during that period over the rest of their training. A negative impact on the psycho-physical well being has been reported by 86% of the FITs. The COVID-19 pandemic had an unparalleled impact on the education, formation and mental state of the cardiologists in training. Regulatory agencies, universities and politicians should make a great effort in the organization and reorganization of the teaching programs of the cardiologists of tomorrow.
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Affiliation(s)
- Antonio Strangio
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro
| | - Isabella Leo
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro
| | | | - Francesco Barillà
- Italian Society of Cardiology (SIC)
- Department of Clinical, Internal, Anesthesiological, and Cardiovascular Sciences, University of Rome Sapienza, Rome
| | - Cristina Basso
- Italian Society of Cardiology (SIC)
- Cardiovascular Pathology Unit, University of Padua, Padua
| | - Maria Pia Calabrò
- Italian Society of Cardiology (SIC)
- Department of Human Pathology, University of Messina, Messina
| | - Antonio Curcio
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro
- Italian Society of Cardiology (SIC)
- Cardiovascular Research Center, Magna Graecia University, Catanzaro
| | - Pasquale Perrone Filardi
- Italian Society of Cardiology (SIC)
- Department of Advanced Biomedical Sciences, Federico II University, Napoli
| | - Massimo Mancone
- Italian Society of Cardiology (SIC)
- Sapienza University of Rome, Rome
| | - Giuseppe Mercuro
- Italian Society of Cardiology (SIC)
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari
| | - Saverio Muscoli
- Italian Society of Cardiology (SIC)
- Department of Medicine, Tor Vergata University of Rome, Rome
| | - Savina Nodari
- Italian Society of Cardiology (SIC)
- Department of Cardiology, University of Brescia and ASST Spedali Civili di Brescia, Brescia
| | - Roberto Pedrinelli
- Italian Society of Cardiology (SIC)
- Cardiac, Thoracic and Vascular Department, University of Pisa, Pisa
| | - Francesco Romeo
- Italian Society of Cardiology (SIC)
- Department of Cardiovascular Disease, Tor Vergata University of Rome, Rome
| | - Gianfranco Sinagra
- Italian Society of Cardiology (SIC)
- Cardiovascular Department, University of Trieste, Trieste
| | - Ciro Indolfi
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro
- Italian Society of Cardiology (SIC)
- Cardiovascular Research Center, Magna Graecia University, Catanzaro
- Mediterranea Cardiocentro, Naples, Italy
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Sarveswaran G, Rangamani S, Ghosh A, Bhansali A, Dharmalingam M, Unnikrishnan AG, Kishore Vikram N, Mathur P, Misra A. Management of diabetes mellitus through teleconsultation during COVID-19 and similar scenarios - Guidelines from Indian Council of Medical Research (ICMR) expert group. Diabetes Metab Syndr 2021; 15:102242. [PMID: 34399274 PMCID: PMC8349457 DOI: 10.1016/j.dsx.2021.102242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 10/29/2022]
Abstract
INTRODUCTION Emergence of COVID-19 pandemic has led to increased use of telemedicine in health care delivery. Telemedicine facilitates long-term clinical care for monitoring and prevention of complications of diabetes mellitus. GUIDELINES Precise indications for teleconsultation, clinical care services which can be provided, and good clinical practices to be followed during teleconsultation are explained. Guidance on risk assessment and health education for diabetes risk factors, counselling for blood glucose monitoring, treatment compliance, and prevention of complications are described. CONCLUSION The guidelines will help physicians in adopting teleconsultation for management of diabetes mellitus, facilitate access to diabetes care and improve health outcomes.
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Affiliation(s)
- Gokul Sarveswaran
- ICMR - National Centre for Disease Informatics and Research (NCDIR), Bengaluru, Karnataka, 562 110, India.
| | - Sukanya Rangamani
- ICMR - National Centre for Disease Informatics and Research (NCDIR), Bengaluru, Karnataka, 562 110, India.
| | - Amerta Ghosh
- Diabetology, Fortis C-DOC Center of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, New Delhi, 110 048, India.
| | - Anil Bhansali
- Department of Endocrinology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160 012, India.
| | - Mala Dharmalingam
- Department of Endocrinology, M S Ramaiah Medical College, Bengaluru, Karnataka, 560 054, India.
| | | | - Naval Kishore Vikram
- Department of Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, 110 029, India.
| | - Prashant Mathur
- ICMR - National Centre for Disease Informatics and Research (NCDIR), Bengaluru, Karnataka, 562 110, India.
| | - Anoop Misra
- Fortis C-DOC Center of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, New Delhi, 110 048, India.
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Thierry AR, Pastor B, Pisareva E, Ghiringhelli F, Bouché O, De La Fouchardière C, Vanbockstael J, Smith D, François E, Dos Santos M, Botsen D, Ellis S, Fonck M, André T, Guardiola E, Khemissa F, Linot B, Martin-Babau J, Rinaldi Y, Assenat E, Clavel L, Dominguez S, Gavoille C, Sefrioui D, Pezzella V, Mollevi C, Ychou M, Mazard T. Association of COVID-19 Lockdown With the Tumor Burden in Patients With Newly Diagnosed Metastatic Colorectal Cancer. JAMA Netw Open 2021; 4:e2124483. [PMID: 34495337 PMCID: PMC8427376 DOI: 10.1001/jamanetworkopen.2021.24483] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
IMPORTANCE The COVID-19 pandemic has been associated with substantial reduction in screening, case identification, and hospital referrals among patients with cancer. However, no study has quantitatively examined the implications of this correlation for cancer patient management. OBJECTIVE To evaluate the association of the COVID-19 pandemic lockdown with the tumor burden of patients who were diagnosed with metastatic colorectal cancer (mCRC) before vs after lockdown. DESIGN, SETTING, AND PARTICIPANTS This cohort study analyzed participants in the screening procedure of the PANIRINOX (Phase II Randomized Study Comparing FOLFIRINOX + Panitumumab vs FOLFOX + Panitumumab in Metastatic Colorectal Cancer Patients Stratified by RAS Status from Circulating DNA Analysis) phase 2 randomized clinical trial. These newly diagnosed patients received care at 1 of 18 different clinical centers in France and were recruited before or after the lockdown was enacted in France in the spring of 2020. Patients underwent a blood-sampling screening procedure to identify their RAS and BRAF tumor status. EXPOSURES mCRC. MAIN OUTCOMES AND MEASURES Circulating tumor DNA (ctDNA) analysis was used to identify RAS and BRAF status. Tumor burden was evaluated by the total plasma ctDNA concentration. The median ctDNA concentration was compared in patients who underwent screening before (November 11, 2019, to March 9, 2020) vs after (May 14 to September 3, 2020) lockdown and in patients who were included from the start of the PANIRINOX study. RESULTS A total of 80 patients were included, of whom 40 underwent screening before and 40 others underwent screening after the first COVID-19 lockdown in France. These patients included 48 men (60.0%) and 32 women (40.0%) and had a median (range) age of 62 (37-77) years. The median ctDNA concentration was statistically higher in patients who were newly diagnosed after lockdown compared with those who were diagnosed before lockdown (119.2 ng/mL vs 17.3 ng/mL; P < .001). Patients with mCRC and high ctDNA concentration had lower median survival compared with those with lower concentration (14.7 [95% CI, 8.8-18.0] months vs 20.0 [95% CI, 14.1-32.0] months). This finding points to the potential adverse consequences of the COVID-19 pandemic and related lockdown. CONCLUSIONS AND RELEVANCE This cohort study found that tumor burden differed between patients who received an mCRC diagnosis before vs after the first COVID-19 lockdown in France. The findings of this study suggest that CRC is a major area for intervention to minimize pandemic-associated delays in screening, diagnosis, and treatment.
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Affiliation(s)
- Alain R. Thierry
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Institut National de la Santé et de la Recherche Médicale (INSERM) U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier, Montpellier, France
| | - Brice Pastor
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Institut National de la Santé et de la Recherche Médicale (INSERM) U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier, Montpellier, France
| | - Ekaterina Pisareva
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Institut National de la Santé et de la Recherche Médicale (INSERM) U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier, Montpellier, France
| | | | | | | | | | - Denis Smith
- Hôpital Haut-Lévêque, Centre Hospitalier Universitaire (CHU) de Bordeaux, Pessac, France
| | | | | | - Damien Botsen
- Medical Oncology Department, Godinot Institute, Reims, France
| | | | | | | | | | | | | | | | - Yves Rinaldi
- Hôpital Européen de Marseille, Marseille, France
| | - Eric Assenat
- Department of Medical Oncology, St Eloi University Hospital, Montpellier, France
| | | | | | - Celine Gavoille
- Institue de Cancérologie de Lorraine, Vadoeuvre-les-Nancy, France
| | | | | | - Caroline Mollevi
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Institut National de la Santé et de la Recherche Médicale (INSERM) U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier, Montpellier, France
| | - Marc Ychou
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Institut National de la Santé et de la Recherche Médicale (INSERM) U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier, Montpellier, France
| | - Thibault Mazard
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Institut National de la Santé et de la Recherche Médicale (INSERM) U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier, Montpellier, France
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Kesavadev J, Basanth A, Krishnan G, Vitale R, Parameswaran H, Shijin S, R S, Raj S, Ashik A, Shankar A, Badarudeen S, Raveendran AV, Rajalakshmy I, Sanal G, Manoj A, Jose R, Unes Y, Jothydev S. A new interventional home care model for COVID management: Virtual Covid IP. Diabetes Metab Syndr 2021; 15:102228. [PMID: 34330071 PMCID: PMC8299213 DOI: 10.1016/j.dsx.2021.102228] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 07/17/2021] [Accepted: 07/19/2021] [Indexed: 02/09/2023]
Abstract
AIM Amidst COVID-19 pandemic, the health care delivery in India faces major challenges owing to the overwhelming hospitals, exhausted healthcare workers, and shortage of crucial medical supplies such as ventilators and oxygen. The study aims to propose a novel successful interventional home care model, the Virtual COVID In-Patient (VCIP) care for effective COVID management. METHODS The Covid-19 positive patients enrolled in VCIP were chosen for the study. A 24/7 active multidisciplinary WhatsApp group was created for each patient, for remote monitoring of temperature, blood pressure, blood glucose, respiratory and pulse rate along with the symptoms. Advice on sleep and exercises were given along with the medication via video-audio consultations. Lab facility was provided at the doorstep. Training on various devices, medications including steroids, delivering subcutaneous injections etc were given via video platforms. RESULTS Among the 220 patients who availed the VCIP facility, only two were hospitalized, yielding a 99.5 % success rate in preventing hospitalizations and patients enrolled have been immensely satisfied with their experience. CONCLUSIONS With similar pandemics anticipated in near future, VCIP model may be considered for successful domiciliary treatment and overcoming the challenges.
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Affiliation(s)
- Jothydev Kesavadev
- Department of Diabetology, Jothydev's Diabetes Research Centers, Kerala, India.
| | - Anjana Basanth
- Department of Diabetology, Jothydev's Diabetes Research Centers, Kerala, India
| | - Gopika Krishnan
- Department of Diabetology, Jothydev's Diabetes Research Centers, Kerala, India
| | - Rebecca Vitale
- Division of Endocrinology, Diabetes, and Hypertension, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Hari Parameswaran
- Department of Hematology Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Sajna Shijin
- Department of Diabetology, Jothydev's Diabetes Research Centers, Kerala, India
| | - Sreelakshmi R
- Department of Diabetology, Jothydev's Diabetes Research Centers, Kerala, India
| | - Sumesh Raj
- Department of Internal Medicine, Sree Gokulam Medical College, Trivandrum, India
| | - Asha Ashik
- Department of Diabetology, Jothydev's Diabetes Research Centers, Kerala, India
| | - Arun Shankar
- Department of Diabetology, Jothydev's Diabetes Research Centers, Kerala, India
| | - Sameer Badarudeen
- Department of Orthopedic Surgery and Sports Medicine, University of Kentucky, USA
| | - A V Raveendran
- Department of Internal Medicine, Badr Al Samaa, Barka, Oman
| | - Indu Rajalakshmy
- Department of Diabetology, Jothydev's Diabetes Research Centers, Kerala, India
| | - Geethu Sanal
- Department of Diabetology, Jothydev's Diabetes Research Centers, Kerala, India
| | - Akhila Manoj
- Department of Diabetology, Jothydev's Diabetes Research Centers, Kerala, India
| | - Remya Jose
- Department of Diabetology, Jothydev's Diabetes Research Centers, Kerala, India
| | - Yaseen Unes
- Department of Diabetology, Jothydev's Diabetes Research Centers, Kerala, India
| | - Sunitha Jothydev
- Department of Diabetology, Jothydev's Diabetes Research Centers, Kerala, India
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Abstract
BACKGROUND Pandemics threaten lives and economies. This article addresses the global threat of the anticipated overlap of COVID-19 with seasonal-influenza. OBJECTIVES Scientific evidence based on simulation methodology is presented to reveal the impact of a dual outbreak, with scenarios intended for propagation analysis. This article aims at researchers, clinicians of family medicine, general practice and policy-makers worldwide. The implications for the clinical practice of primary health care are discussed. Current research is an effort to explore new directions in epidemiology and health services delivery. METHODS Projections consisted of machine learning, dynamic modelling algorithms and whole simulations. Input data consisted of global indicators of infectious diseases. Four simulations were run for '20% versus 60% flu-vaccinated populations' and '10 versus 20 personal contacts'. Outputs consisted of numerical values and mathematical graphs. Outputs consisted of numbers for 'never infected', 'vaccinated', 'infected/recovered', 'symptomatic/asymptomatic' and 'deceased' individuals. Peaks, percentages, R0, durations are reported. RESULTS The best-case scenario was one with a higher flu-vaccination rate and fewer contacts. The reverse generated the worst outcomes, likely to disrupt the provision of vital community services. Both measures were proven effective; however, results demonstrated that 'increasing flu-vaccination rates' is a more powerful strategy than 'limiting social contacts'. CONCLUSIONS Results support two affordable preventive measures: (i) to globally increase influenza-vaccination rates, (ii) to limit the number of personal contacts during outbreaks. The authors endorse changing practices and research incentives towards multidisciplinary collaborations. The urgency of the situation is a call for international health policy to promote interdisciplinary modern technologies in public health engineering.
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Affiliation(s)
- Verda Tunaligil
- SIMMERK Medical Simulation Center, Division of Public Health and Department of Emergency, Disaster Medical Services, TR MoH Health Directorate of Istanbul, Istanbul, Turkey
| | - Gulsen Meral
- President’s Office and Department of Pediatrics, Nutrigenetics and Epigenetics Association, Istanbul, Turkey
| | - Mustafa Resat Dabak
- Department of Family Medicine, Divisions of Residency Training Programs and Clinical Practice Chieftaincy, TR MoH Haseki Research and Training Hospital, Istanbul, Turkey
| | - Mehmet Canbulat
- Department of Data Management, Turkish Airlines, Istanbul, Turkey
- Department of Data Science, Robert Koch Institute, Berlin, Germany
| | - Sıddıka Semahat Demir
- President’s Office and Departments of Biomedical, Electrical, Computer Engineering, Science Heroes Association, Istanbul, Turkey
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