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2.
J Environ Sci (China) ; 124: 933-951, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36182196

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented worldwide health crisis. Many previous research studies have found and investigated its links with one or some natural or human environmental factors. However, a review on the relationship between COVID-19 incidence and both the natural and human environment is still lacking. This review summarizes the inter-correlation between COVID-19 incidence and environmental factors. Based on keyword searching, we reviewed 100 relevant peer-reviewed articles and other research literature published since January 2020. This review is focused on three main findings. One, we found that individual environmental factors have impacts on COVID-19 incidence, but with spatial heterogeneity and uncertainty. Two, environmental factors exert interactive effects on COVID-19 incidence. In particular, the interactions of natural factors can affect COVID-19 transmission in micro- and macro- ways by impacting SARS-CoV-2 survival, as well as human mobility and behaviors. Three, the impact of COVID-19 incidence on the environment lies in the fact that COVID-19-induced lockdowns caused air quality improvement, wildlife shifts and socio-economic depression. The additional value of this review is that we recommend future research perspectives and adaptation strategies regarding the interactions of the environment and COVID-19. Future research should be extended to cover both the effects of the environment on the COVID-19 pandemic and COVID-19-induced impacts on the environment. Future adaptation strategies should focus on sustainable environmental and public policy responses.


Assuntos
Poluição do Ar , COVID-19 , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Humanos , Pandemias , SARS-CoV-2
3.
J Hazard Mater ; 441: 129848, 2023 01 05.
Artigo em Inglês | MEDLINE | ID: mdl-36067562

RESUMO

Wastewater-based epidemiology (WBE) has been considered as a promising approach for population-wide surveillance of coronavirus disease 2019 (COVID-19). Many studies have successfully quantified severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA concentration in wastewater (CRNA). However, the correlation between the CRNA and the COVID-19 clinically confirmed cases in the corresponding wastewater catchments varies and the impacts of environmental and other factors remain unclear. A systematic review and meta-analysis were conducted to identify the correlation between CRNA and various types of clinically confirmed case numbers, including prevalence and incidence rates. The impacts of environmental factors, WBE sampling design, and epidemiological conditions on the correlation were assessed for the same datasets. The systematic review identified 133 correlation coefficients, ranging from -0.38 to 0.99. The correlation between CRNA and new cases (either daily new, weekly new, or future cases) was stronger than that of active cases and cumulative cases. These correlation coefficients were potentially affected by environmental and epidemiological conditions and WBE sampling design. Larger variations of air temperature and clinical testing coverage, and the increase of catchment size showed strong negative impacts on the correlation between CRNA and COVID-19 case numbers. Interestingly, the sampling technique had negligible impact although increasing the sampling frequency improved the correlation. These findings highlight the importance of viral shedding dynamics, in-sewer decay, WBE sampling design and clinical testing on the accurate back-estimation of COVID-19 case numbers through the WBE approach.


Assuntos
COVID-19 , COVID-19/epidemiologia , Humanos , RNA Viral/genética , SARS-CoV-2/genética , Águas Residuárias , Vigilância Epidemiológica Baseada em Águas Residuárias
4.
J Theor Biol ; 556: 111296, 2023 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-36208669

RESUMO

Seroprevalence studies can estimate proportions of the population that have been infected or vaccinated, including infections that were not reported because of the lack of symptoms or testing. Based on information from studies in the United States from mid-summer 2020 through the end of 2021, we describe proportions of the population with antibodies to SARS-CoV-2 as functions of age and time. Slices through these surfaces at arbitrary times provide initial and target conditions for simulation modeling. They also provide the information needed to calculate age-specific forces of infection, attack rates, and - together with contact rates - age-specific probabilities of infection on contact between susceptible and infectious people. We modified the familiar Susceptible-Exposed-Infectious-Removed (SEIR) model to include features of the biology of COVID-19 that might affect transmission of SARS-CoV-2 and stratified by age and location. We consulted the primary literature or subject matter experts for contact rates and other parameter values. Using time-varying Oxford COVID-19 Government Response Tracker assessments of US state and DC efforts to mitigate the pandemic and compliance with non-pharmaceutical interventions (NPIs) from a YouGov survey fielded in the US during 2020, we estimate that the efficacy of social-distancing when possible and mask-wearing otherwise at reducing susceptibility or infectiousness was 31% during the fall of 2020. Initialized from seroprevalence among people having commercial laboratory tests for purposes other than SARS-CoV-2 infection assessments on 7 September 2020, our age- and location-stratified SEIR population model reproduces seroprevalence among members of the same population on 25 December 2020 quite well. Introducing vaccination mid-December 2020, first of healthcare and other essential workers, followed by older adults, people who were otherwise immunocompromised, and then progressively younger people, our metapopulation model reproduces seroprevalence among blood donors on 4 April 2021 less well, but we believe that the discrepancy is due to vaccinations being under-reported or blood donors being disproportionately vaccinated, if not both. As experimenting with reliable transmission models is the best way to assess the indirect effects of mitigation measures, we determined the impact of vaccination, conditional on NPIs. Results indicate that, during this period, vaccination substantially reduced infections, hospitalizations and deaths. This manuscript was submitted as part of a theme issue on "Modelling COVID-19 and Preparedness for Future Pandemics."


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , Estados Unidos/epidemiologia , Idoso , COVID-19/epidemiologia , Estudos Soroepidemiológicos , Pandemias/prevenção & controle
5.
J Theor Biol ; 556: 111299, 2023 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-36252843

RESUMO

One of the key features of any infectious disease is whether infection generates long-lasting immunity or whether repeated reinfection is common. In the former, the long-term dynamics are driven by the birth of susceptible individuals while in the latter the dynamics are governed by the speed of waning immunity. Between these two extremes a range of scenarios is possible. During the early waves of SARS-CoV-2, the underlying paradigm was for long-lasting immunity, but more recent data and in particular the 2022 Omicron waves have shown that reinfection can be relatively common. Here we investigate reported SARS-CoV-2 cases in England, partitioning the data into four main waves, and consider the temporal distribution of first and second reports of infection. We show that a simple low-dimensional statistical model of random (but scaled) reinfection captures much of the observed dynamics, with the value of this scaling, k, providing information of underlying epidemiological patterns. We conclude that there is considerable heterogeneity in risk of reporting reinfection by wave, age-group and location. The high levels of reinfection in the Omicron wave (we estimate that 18% of all Omicron cases had been previously infected, although not necessarily previously reported infection) point to reinfection events dominating future COVID-19 dynamics. This manuscript was submitted as part of a theme issue on "Modelling COVID-19 and Preparedness for Future Pandemics".


Assuntos
COVID-19 , Reinfecção , Humanos , Reinfecção/epidemiologia , SARS-CoV-2 , COVID-19/epidemiologia , Pandemias , Inglaterra/epidemiologia
6.
J Environ Sci (China) ; 125: 843-850, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36375966

RESUMO

With a unique and large size of testing results of 1,842 samples collected from 12 wastewater treatment plants (WWTP) for 14 months through from low to high prevalence of COVID-19, the sensitivity of RT-qPCR detection of SARS-CoV-2 RNA in wastewater that correspond to the communities was computed by using Probit analysis. This study determined the number of new COVID-19 cases per 100,000 population required to detect SARS-CoV-2 RNA in wastewater at defined probabilities and provided an evidence-based framework of wastewater-based epidemiology surveillance (WBE). Input data were positive and negative test results of SARS-CoV-2 RNA in wastewater samples and the corresponding new COVID-19 case rates per 100,000 population served by each WWTP. The analyses determined that RT-qPCR-based SARS-CoV-2 RNA detection threshold at 50%, 80% and 99% probability required a median of 8 (range: 4-19), 18 (9-43), and 38 (17-97) of new COVID-19 cases /100,000, respectively. Namely, the positive detection rate at 50%, 80% and 99% probability were 0.01%, 0.02%, and 0.04% averagely for new cases in the population. This study improves understanding of the performance of WBE SARS-CoV-2 RNA detection using the large datasets and prolonged study period. Estimated COVID-19 burden at a community level that would result in a positive detection of SARS-CoV-2 in wastewater is critical to support WBE application as a supplementary warning/monitoring system for COVID-19 prevention and control.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , SARS-CoV-2/genética , Águas Residuárias/análise , RNA Viral/genética , RNA Viral/análise , Alberta/epidemiologia
8.
J Environ Sci (China) ; 125: 603-615, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36375942

RESUMO

Wuhan Tianhe International Airport (WUH) was suspended to contain the spread of COVID-19, while Shanghai Hongqiao International Airport (SHA) saw a tremendous flight reduction. Closure of a major international airport is extremely rare and thus represents a unique opportunity to straightforwardly observe the impact of airport emissions on local air quality. In this study, a series of statistical tools were applied to analyze the variations in air pollutant levels in the vicinity of WUH and SHA. The results of bivariate polar plots show that airport SHA and WUH are a major source of nitrogen oxides. NOx, NO2 and NO diminished by 55.8%, 44.1%, 76.9%, and 40.4%, 33.3% and 59.4% during the COVID-19 lockdown compared to those in the same period of 2018 and 2019, under a reduction in aircraft activities by 58.6% and 61.4%. The concentration of NO2, SO2 and PM2.5 decreased by 77.3%, 8.2%, 29.5%, right after the closure of airport WUH on 23 January 2020. The average concentrations of NO, NO2 and NOx scatter plots at downwind of SHA after the lockdown were 78.0%, 47.9%, 57.4% and 62.3%, 34.8%, 41.8% lower than those during the same period in 2018 and 2019. However, a significant increase in O3 levels by 50.0% and 25.9% at WUH and SHA was observed, respectively. These results evidently show decreased nitrogen oxides concentrations in the airport vicinity due to reduced aircraft activities, while amplified O3 pollution due to a lower titration by NO under strong reduction in NOx emissions.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , COVID-19 , Humanos , Aeroportos , Emissões de Veículos/análise , Dióxido de Nitrogênio/análise , COVID-19/epidemiologia , China , Controle de Doenças Transmissíveis , Poluição do Ar/análise , Poluentes Atmosféricos/análise , Aeronaves , Óxidos de Nitrogênio/análise , Monitoramento Ambiental/métodos , Material Particulado/análise
9.
J Affect Disord ; 321: 126-133, 2023 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-36280200

RESUMO

BACKGROUND: Evidence on the relationship between burnout and post-traumatic stress disorder (PTSD) is limited. We aimed to evaluate the association between burnout and PTSD symptoms among medical staff two years after the coronavirus disease 2019 (COVID-19) pandemic in Wuhan, China, and explore the mediating roles of social support and psychological resilience. METHODS: A multicenter survey was conducted online from January to March 2022 among healthcare professionals from six general hospitals. Hierarchical linear regression was used to detect the predictors of PTSD symptoms. Structural equation modeling (SEM) was used to analyze the pathways from burnout to PTSD symptoms. RESULTS: Hierarchical linear regression showed that burnout, social support, and psychological resilience were significant predictors of PTSD symptoms among medical staff. In the SEM, the standardized total effect of burnout on PTSD symptoms was 0.336(bias-corrected 95 % confidence interval [0.303, 0.367], P < 0.001). Social support and psychological resilience partially mediated the relationship between burnout and PTSD symptoms (indirect effects accounted for 22.3 % of the total effect). LIMITATIONS: Owing to the cross-sectional design, only clues to causal explanations can be provided. CONCLUSIONS: Burnout has significant direct and indirect effects on PTSD symptoms. Furthermore, social support and psychological resilience might be effective ways to reduce the impact of burnout on PTSD symptoms in medical staff after a major public health outbreak.


Assuntos
Esgotamento Profissional , COVID-19 , Transtornos de Estresse Pós-Traumáticos , Humanos , Transtornos de Estresse Pós-Traumáticos/psicologia , Pandemias , COVID-19/epidemiologia , Estudos Transversais , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/psicologia , Apoio Social , Esgotamento Psicológico , China/epidemiologia , Corpo Clínico
10.
J Theor Biol ; 557: 111329, 2023 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-36309117

RESUMO

Susceptible-exposed-infectious-recovered (SEIR) models were applied to assess the effectiveness of non-pharmaceutical interventions (NPIs) and to study the dynamic behavior of the COVID-19 pandemic. Recently, SEIR models have evolved to address the change of human mobility by some NPIs for predicting the new confirmed cases. However, the models have serious limitations when applied to Seoul. Seoul has two representative quarantine policies, i.e. social distancing and the ban on gatherings. Effects of the two policies need to be reflected in different functional forms in the model because changes in human mobility do not fully reflect the ban on gatherings. Thus we propose a modified SEIR model to assess the effectiveness of social distancing, ban on gatherings and vaccination strategies. The application of the modified SEIR model was illustrated by comparing the model output with real data.


Assuntos
COVID-19 , Doenças Transmissíveis , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Pandemias/prevenção & controle , Seul , Quarentena , Distanciamento Físico , Suscetibilidade a Doenças
11.
J Theor Biol ; 557: 111336, 2023 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-36323394

RESUMO

The COVID-19 epidemic has lasted for more than two years since the outbreak in late 2019. An urgent and challenging question is how to systematically evaluate epidemic developments in different countries, during different periods, and to determine which measures that could be implemented are key for successful epidemic prevention. In this study, SBD distance-based K-shape clustering and hierarchical clustering methods were used to analyse epidemics in Asian countries. For the hierarchical clustering, epidemic time series were divided into three periods (epidemics induced by the Original/Alpha, Delta and Omicron variants separately). Standard deviations, the Hurst index, mortality rates, peak value of confirmed cases per capita, average growth rates, and the control efficiency of each period were used to characterize the epidemics. In addition, the total numbers of cases in the different countries were analysed by correlation and regression in relation to 15 variables that could have impacts on COVID-19. Finally, some suggestions on prevention and control measures for each category of country are given. We found that the total numbers of cases per million of a population, total deaths per million and mortality rates were highly correlated with the proportion of people aged over 65 years, the prevalence of multiple diseases, and the national GDP. We also found significant associations between case numbers and vaccination rates, health expenditures, and stringency of control measures. Vaccinations have played a positive role in COVID-19, with a gradual decline in mortality rates in later periods, and are still playing protective roles against the Delta and Omicron strains. The stringency of control measures taken by a government is not an indicator of the appropriateness of a country's response to the outbreak, and a higher index does not necessarily mean more effective measures; a combination of factors such as national vaccination rates, the country's economic foundation and the availability of medical equipment is also needed. This manuscript was submitted as part of a theme issue on "Modelling COVID-19 and Preparedness for Future Pandemics".


Assuntos
COVID-19 , Humanos , Idoso , COVID-19/epidemiologia , SARS-CoV-2 , Pandemias , Ásia/epidemiologia
12.
J Theor Biol ; 557: 111332, 2023 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-36323393

RESUMO

In March 2020 mathematics became a key part of the scientific advice to the UK government on the pandemic response to COVID-19. Mathematical and statistical modelling provided critical information on the spread of the virus and the potential impact of different interventions. The unprecedented scale of the challenge led the epidemiological modelling community in the UK to be pushed to its limits. At the same time, mathematical modellers across the country were keen to use their knowledge and skills to support the COVID-19 modelling effort. However, this sudden great interest in epidemiological modelling needed to be coordinated to provide much-needed support, and to limit the burden on epidemiological modellers already very stretched for time. In this paper we describe three initiatives set up in the UK in spring 2020 to coordinate the mathematical sciences research community in supporting mathematical modelling of COVID-19. Each initiative had different primary aims and worked to maximise synergies between the various projects. We reflect on the lessons learnt, highlighting the key roles of pre-existing research collaborations and focal centres of coordination in contributing to the success of these initiatives. We conclude with recommendations about important ways in which the scientific research community could be better prepared for future pandemics. This manuscript was submitted as part of a theme issue on "Modelling COVID-19 and Preparedness for Future Pandemics".


Assuntos
COVID-19 , Pandemias , Humanos , Pandemias/prevenção & controle , COVID-19/epidemiologia , Aprendizagem , Matemática , Reino Unido/epidemiologia
13.
J Theor Biol ; 557: 111335, 2023 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-36334850

RESUMO

Repeat asymptomatic testing in order to identify and quarantine infectious individuals has become a widely-used intervention to control SARS-CoV-2 transmission. In some workplaces, and in particular health and social care settings with vulnerable patients, regular asymptomatic testing has been deployed to staff to reduce the likelihood of workplace outbreaks. We have developed a model based on data available in the literature to predict the potential impact of repeat asymptomatic testing on SARS-CoV-2 transmission. The results highlight features that are important to consider when modelling testing interventions, including population heterogeneity of infectiousness and correlation with test-positive probability, as well as adherence behaviours in response to policy. Furthermore, the model based on the reduction in transmission potential presented here can be used to parameterise existing epidemiological models without them having to explicitly simulate the testing process. Overall, we find that even with different model paramterisations, in theory, regular asymptomatic testing is likely to be a highly effective measure to reduce transmission in workplaces, subject to adherence. This manuscript was submitted as part of a theme issue on "Modelling COVID-19 and Preparedness for Future Pandemics".


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/prevenção & controle , Políticas , Surtos de Doenças , Quarentena
14.
J Affect Disord ; 321: 167-181, 2023 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-36341802

RESUMO

BACKGROUND: This meta-analysis and systematic review aimed to evaluate the global prevalence and risk factors of mental problems (i.e., depression, anxiety, stress, sleep disorder, posttraumatic stress disorder (PTSD), burnout, psychological distress, and suicidal ideation) among medical students during the COVID-19 pandemic. METHOD: We searched PubMed, Embase, Web of Science, psycARTICLES, PsycINFO, CNKI, and Wan Fang for studies on the prevalence of mental problems among medical students from January 1, 2020, to April 1, 2022. The pooled prevalence was calculated by random-effect models. We performed a narrative review to identify the risk factors. RESULTS: The meta-analysis included 201 studies (N = 198,000). The prevalence of depression (41 %, 95 % CI, 37-45 %,), anxiety (38 %,95 % CI, 34 %-42 %), stress (34 %, 95 % CI, 27 %-42 %), sleep disorder (52 %, 95 % CI, 44 %-60 %), psychological distress (58 %, 95 % CI, 51 %-65 %), PTSD (34 %, 95 % CI, 22 %-46 %), suicidal ideation (15 %, 95 % CI, 11 %-18 %) and burnout (38 %, 95 % CI, 25 %-50 %) was high. The major risk factors were being female, being junior or preclinical students, exposure to COVID-19, academic stress, psychiatric or physical disorders history, economic trouble, fear of education impairment, online learning trouble, fear of infection, loneliness, low physical activity, low social support, problematic internet or smartphone use, and young age. LIMITATIONS: Most studies were cross-sectional. Few studies provided a reasonable response rate, suggesting potential selection bias. CONCLUSIONS: The study demonstrated a high prevalence and risk factors for mental problems during COVID-19, calling for mental health services. Our findings are valuable for college and health authorities to identify high-risk students and provide targeted intervention.


Assuntos
COVID-19 , Transtornos do Sono-Vigília , Estudantes de Medicina , Feminino , Humanos , Masculino , COVID-19/epidemiologia , Prevalência , Pandemias , Fatores de Risco , Transtornos do Sono-Vigília/epidemiologia
15.
J Infect Chemother ; 29(1): 105-108, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36113847

RESUMO

Acute exacerbations due to COVID-19 vaccination in patients with interstitial lung disease (ILD) have been reported, but their incidence is unknown. We investigated the incidence of exacerbations of ILD and respiratory symptoms due to the mRNA COVID-19 vaccines. A questionnaire survey was conducted on adverse reactions to the mRNA COVID-19 vaccination in 545 patients with ILD attending our hospital and retrospectively examined whether the eligible patients actually developed acute exacerbations of ILD induced by the vaccine. Of the 545 patients, 17 (3.1%) patients were aware of the exacerbation of respiratory symptoms, and four (0.7%) patients developed an acute ILD exacerbation after vaccination. Of the four patients who experienced exacerbations, two had collagen vascular disease-associated ILD, one had nonspecific interstitial pneumonia, another had unclassifiable idiopathic pneumonia, and none had idiopathic pulmonary fibrosis. Four patients were treated using steroid pulse therapy with a steroid taper, and two of the four also received intravenous cyclophosphamide pulse therapy. Tacrolimus was started in one patient with myositis-associated interstitial lung disease. Eventually, all patients exhibited improvement with immunosuppressive treatment and were discharged. COVID-19 vaccination for patients with ILD should be noted for developing acute exacerbations of ILD with low incidence, although manageable with early diagnosis and treatment.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Doenças Pulmonares Intersticiais , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Progressão da Doença , Incidência , Doenças Pulmonares Intersticiais/tratamento farmacológico , Doenças Pulmonares Intersticiais/epidemiologia , Doenças Pulmonares Intersticiais/etiologia , Estudos Retrospectivos , RNA Mensageiro , Vacinação/efeitos adversos
16.
Sci Total Environ ; 855: 158766, 2023 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-36116669

RESUMO

The Covid-19 crisis has caused several social-related issues; the sanitary is, perhaps, the most significant one. Lockdowns and vaccination were implemented to fight the Covid-19 virus. From a sustainability perspective, Covid-19 has been considered a meaningful crisis driver that has affected nations' economies and social and natural capitals. The literature presents clues that effects appear to be different among countries. Recognizing its importance as public policies for sustainability, this study aims to assess how the sustainability of countries has changed after Covid-19, focusing on countries' economic power that reflects their capacity to face the crisis. A sample of 89 countries is considered, and 2019-2020 are set as base years for data gathering, which covers the first year of the Covid-19 crisis. Sustainability is conceptually supported and represented by a 3-D cube. The natural environment is expressed by the ecological footprint (EF) method, the economic capital by the gross domestic product (GDP), and the social capital by the happiness index. Results show that sustainability of economies was negatively affected after first year of Covid-19 crisis, but in different magnitudes, according to nations' economic power. While the sustainability of the wealthiest economies was slightly changed during 2019-2020 but maintained within the named 'useful-order' world (environmentally unsustainable, productive, and happy), the poorest economies pushed about 169 million people into the worst performance, reaching the 'ineffective' world (environmentally unsustainable, unproductive, and unhappy). Numbers highlight the inequalities of sustainability performance among countries, according to their capacity to face the Covid-19 crisis. The shield of the richest evaluated countries comprising 5 % of the world population is more powerful than the shield of the poorest evaluated countries carrying 67 % of the world population. Results claims for efforts to make different policies and provide economic support differently for countries, since although we are all under the same storm, but in different boats.


Assuntos
COVID-19 , Pandemias , Humanos , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Produto Interno Bruto , Meio Ambiente
17.
Sci Total Environ ; 855: 158967, 2023 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-36162580

RESUMO

Public health surveillance systems for COVID-19 are multifaceted and include multiple indicators reflective of different aspects of the burden and spread of the disease in a community. With the emergence of wastewater disease surveillance as a powerful tool to track infection dynamics of SARS-CoV-2, there is a need to integrate and validate wastewater information with existing disease surveillance systems and demonstrate how it can be used as a routine surveillance tool. A first step toward integration is showing how it relates to other disease surveillance indicators and outcomes, such as case positivity rates, syndromic surveillance data, and hospital bed use rates. Here, we present an 86-week long surveillance study that covers three major COVID-19 surges. City-wide SARS-CoV-2 RNA viral loads in wastewater were measured across 39 wastewater treatment plants and compared to other disease metrics for the city of Houston, TX. We show that wastewater levels are strongly correlated with positivity rate, syndromic surveillance rates of COVID-19 visits, and COVID-19-related general bed use rates at hospitals. We show that the relative timing of wastewater relative to each indicator shifted across the pandemic, likely due to a multitude of factors including testing availability, health-seeking behavior, and changes in viral variants. Next, we show that individual WWTPs led city-wide changes in SARS-CoV-2 viral loads, indicating a distributed monitoring system could be used to enhance the early-warning capability of a wastewater monitoring system. Finally, we describe how the results were used in real-time to inform public health response and resource allocation.


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , COVID-19/epidemiologia , Águas Residuárias , RNA Viral , Pandemias
18.
J Affect Disord ; 320: 148-160, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36179778

RESUMO

BACKGROUND: An increasing number of research has documented the positive associations between psychological inflexibility (PI) and mental health problems (i.e., depressive, anxiety, and stress symptoms) during the COVID-19 pandemic. However, the documented associations have been inconsistent. This review thus aimed to quantitatively summarize primary research to gain better estimates of these associations. METHODS: A systematic literature review was conducted in six databases and three-level meta-analytic models were used to statistically synthesize effect sizes and to examine moderators of the associations between PI and depressive, anxiety, and stress symptoms. RESULTS: A total of 22 studies yielded 63 effect sizes on associations between PI and depressive, anxiety, or stress symptoms. The results of three separate meta-analyses revealed a large and significant association between PI and depressive (r = 0.580, 95 % CI [0.549; 0.775]), anxiety (r = 0.548, 95 % CI [0.468; 0.761]), and stress symptoms (r = 0.548, 95 % CI [0.506; 0.725]). The association between PI and depressive symptoms is stronger for males than for females, and the association between PI and stress symptoms varies by type of measure that primary studies use to assess PI and stress symptoms. LIMITATIONS: Temporal or causal conclusions are not allowed due to cross-sectional nature of the associations included in meta-analyses. Clinical samples with high levels of stress were underrepresented. CONCLUSIONS: PI seems an important risk factor for symptoms of depression, anxiety, and stress, and should therefore be targeted in interventions addressing mental health problems during the COVID-19 pandemic and beyond.


Assuntos
COVID-19 , Humanos , Masculino , Feminino , COVID-19/epidemiologia , Pandemias , Saúde Mental , Estudos Transversais , Ansiedade/psicologia , Depressão/psicologia
19.
J Affect Disord ; 320: 517-524, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36191645

RESUMO

BACKGROUND: The first goal of this study was to assess longitudinal changes in burnout among psychotherapists prior to (T1) and during the COVID-19 pandemic (T2). The second objective was to assess the effects of job demands, job resources (including organizational support for evidence-based psychotherapies, or EBPs) and pandemic-related stress (T2 only) on burnout. METHOD: Psychotherapists providing EBPs for posttraumatic stress disorder in U.S. Department of Veterans Affairs (VA) facilities completed surveys assessing burnout, job resources, and job demands prior to (T1; n = 346) and during (T2; n = 193) the COVID-19 pandemic. RESULTS: Burnout prevalence increased from 40 % at T1 to 56 % at T2 (p < .001). At T1, stronger implementation climate and implementation leadership (p < .001) and provision of only cognitive processing therapy (rather than use of prolonged exposure therapy or both treatments; p < .05) reduced burnout risk. Risk factors for burnout at T2 included T1 burnout, pandemic-related stress, less control over when and how to deliver EBPs, being female, and being a psychologist rather than social worker (p < .02). Implementation leadership did not reduce risk of burnout at T2. LIMITATIONS: This study involved staff not directly involved in treating COVID-19, in a healthcare system poised to transition to telehealth delivery. CONCLUSION: Organizational support for using EBPs reduced burnout risk prior to but not during the pandemic. Pandemic related stress rather than increased work demands contributed to elevated burnout during the pandemic. A comprehensive approach to reducing burnout must address the effects of both work demands and personal stressors.


Assuntos
Esgotamento Profissional , COVID-19 , Veteranos , Humanos , Feminino , Masculino , COVID-19/epidemiologia , COVID-19/prevenção & controle , Pandemias/prevenção & controle , Psicoterapeutas , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/psicologia , Inquéritos e Questionários , Satisfação no Emprego
20.
J Affect Disord ; 320: 275-283, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36191642

RESUMO

BACKGROUND: To study the longitudinal impact of co-occurring mental health problems, and to identify vulnerable groups in need of mental health support during the COVID-19 pandemic. METHODS: Analyses were based on data from 681 French participants in the international COVID-19 Mental Health Study, collected at four times (05/2020-04/2021). Symptoms of depression, anxiety and post-traumatic stress disorder (PTSD) were assessed using the Patient Health Questionnaire 9, the Generalized Anxiety Disorder-7 and the PTSD Check List for DSM-5. We performed k-means for longitudinal data to build trajectories of adults' depression, anxiety and PTSD symptoms and identify subgroups psychologically vulnerable. We then assessed whether mental health trajectories were predicted by lockdown regulations. RESULTS: A high and a low cluster of mental health scores were identified. In both groups, mental health scores varied significantly across time. Levels of all mental health scores were lowest when COVID-19-related restrictions were lifted and highest when restrictions were in place, except for PTSD. No scores returned to the previous level or the initial level of mental health (p < 0.05). Participants with high levels of symptoms were characterized by younger age (OR: 0.98, 95 % CI: 0.97-0.99), prior history of mental disorders (OR: 3.46, 95 % CI: 2.07-5.82), experience of domestic violence (OR: 10.54, 95 % CI: 1.54-20.68) and medical issues (OR: 2.16, 95 % CI: 1.14-4.03). LIMITATIONS: Pre-pandemic data were not available and the sample was recruited mainly by snowball sampling. CONCLUSION: This study revealed subtle differences in the evolution of symptom trajectories during the first year of the Covid-19 pandemic, and highlighted several characteristics associated with the two clusters.


Assuntos
COVID-19 , Transtornos de Estresse Pós-Traumáticos , Humanos , Adulto , Pandemias , COVID-19/epidemiologia , Saúde Mental , Depressão/psicologia , Controle de Doenças Transmissíveis , Ansiedade/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia
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