Fundamental limitations on efficiently forecasting certain epidemic measures in network models.

The ongoing COVID-19 pandemic underscores the importance of developing reliable forecasts that would allow decision makers to devise appropriate response strategies. Despite much recent research on the topic, epidemic forecasting remains poorly understood. Researchers have attributed the difficulty of forecasting contagion dynamics to a multitude of factors, including complex behavioral responses, uncertainty in data, the stochastic nature of the underlying process, and the high sensitivity of the disease parameters to changes in the environment. We offer a rigorous explanation of the difficulty of short-term forecasting on networked populations using ideas from computational complexity. Specifically, we show that several forecasting problems (e.g., the probability that at least a given number of people will get infected at a given time and the probability that the number of infections will reach a peak at a given time) are computationally intractable. For instance, efficient solvability of such problems would imply that the number of satisfying assignments of an arbitrary Boolean formula in conjunctive normal form can be computed efficiently, violating a widely believed hypothesis in computational complexity. This intractability result holds even under the ideal situation, where all the disease parameters are known and are assumed to be insensitive to changes in the environment. From a computational complexity viewpoint, our results, which show that contagion dynamics become unpredictable for both macroscopic and individual properties, bring out some fundamental difficulties of predicting disease parameters. On the positive side, we develop efficient algorithms or approximation algorithms for restricted versions of forecasting problems.

[The modeling of measures of prevention and shaping proper behavior in population as tool of averting redundant risks of morbidity and mortality as exemplified by COVID-19 pandemic].

The article considers issues of how population behavior impacts realization of state anti-epidemic measures and efforts to control pandemic. Materials and Methods. The methodology of the study is based on such methods as text analysis, elastic network and construction of regression equations. The analysis of indicators characterizing state policy measures controlling pandemic was applied according to data from The Oxford COVID-19 Government Response Tracker portal. The behavioral reactions of population were assessed by text analysis of messages in Twitter and VKontakte social networks using the Rulexicon, tonalities dictionary of Russian language. The analysis of mobility was implemented on basis of data from Google Community Mobility Reports (GCMR). The study base includes data of March 12, 2020 - August 1, 2021. It is established that in controlling pandemic the most effective is to apply combination of measures implemented at state level of the Ministry of Health and the Ministry of Economic Development of the Russian Federation that permits to compensate negative effect of quarantine regimen. In the Russian Federation,effect of self-isolation measures, organization of remote work of employees of enterprises, closure of schools, wearing masks is controversial and their incorrect application can contribute to virus propagation. The vaccination measures are also effective in reducing morbidity of disease, but they are characterized by lagging effect. The approval and acceptance by population anti-epidemic measures significantly impact efficiency of pandemic control. The study results can be applied in practice of implementation of anti-epidemic measures as a tool preventing excessive risks of population morbidity and mortality.

[Lessons learnt from COVID-19: technology for organizing a forced self-isolation regime].

The lessons of COVID-19 have confirmed the effectiveness of measures aimed at strict self-isolation and quarantine. In the People's Republic of China, where any violation of the regime requirements was qualified as a criminal offense, the virus was neutralized when the pandemic was only gaining momentum in Europe and America. However, without proper organization of a restrictive regime, self-isolation can lead to negative consequences in terms of deterioration of health and standard of living. The pandemic has undoubtedly significantly complicated our lives, has taken millions of lives, caused disability, deterioration of material status, rupture of marital ties. One of the reasons for this development of events was the unsatisfactory organization of leisure during self-isolation. The inability to calmly wait out, endure COVID-associated adversities in most countries caused mass popular unrest, gave rise to panic moods. Only those who managed to curb the negative consequences and direct them in the right direction managed to come out of the pandemic with dignity. The authors have developed an organizational technology of the forced self-isolation regime based on the complex of measures and proposed this technology for introduction to daily life of the population during the period of restrictive regimes. The authors are sure that it is especially important to organize leisure and create the most comfortable conditions of the isolated living for the elderly, who are the most sensitive to changes in life stereotypes. The authors propose a set of measures to efficiently organize leisure during self-isolation with physical therapy, cognitive training, as well as measures to fit the body and develop psychological relief, making it possible to reverse the threat of the pandemic in higher health potential and better family relations.

[The historical case of discussion on sanitary anti-epidemic activities during period of revolutionary events of 1917 in Irkutsk].

The article presents analysis of historical case of discussion about organization of anti-epidemic measures needed because of one-time arrival of large number of wounded and killed in consequence of counter-revolutionary mutiny in Irkutsk during defense of the White House country-house in December 1917. The problem of burial of fallen soldiers and Red Army men was determined during extraordinary session of the City Duma of Irkutsk with further publication of open letter to the Irkutsk Presidium of the Soviets. The well-reasoned positions expressed by physicians and engineers against burial of the killed in common grave on the banks of the Angara River received no support from the revolutionary government. The chronology of the decision taking had political character.

[The medical social technology of health preservation of elderly population in conditions of self-isolation].

In Moscow (as of January 1, 2020), the number of population made up to 12,678,079, and out of them the elderly population made up to 2.8 million. Up to the end of 2020, the number of the elderly will reach 3.3 million requiring implementation of corresponding preventive measures due to mass prevalence of coronavirus infection. The COVID-19 pandemic demonstrated that despite restructuring of functioning of industry, social security and health care, quarantine and self-isolation occurred to be exactly the effective measures. The self-isolation regimen also revealed aggravation of harmful effects of stress factors, hypodynamia, hypooxygenation and decreasing of immunological resistance. It is especially important to organize leisure activities and to create the most comfortable conditions for isolated living of the elderly as most susceptible to infection. The experience demonstrated that properly chosen set of activities during self-isolation regimen both disciplines and permits to apply surplus of free time to intensify health potential and to consolidate family relationships.

Paediatrics in Theresienstadt ghetto.

The main objective of this study is to describe the most common childhood diseases occurring in the Theresienstadt ghetto during the Second World War as well as applied anti-epidemic measures. A partial objective is to describe medical and nursing care of sick child prisoners. The data was obtained by the method of synthesis of primary and secondary data with the highest importance after adequate external source criticism using selected monographs, memoirs, survivor diaries, Orders of the day by the Council of the Elders and Reports of the Jewish self-government of the Theresienstadt ghetto from 1941 to 1945, the Archives of the Jewish Museum in Prague, the Ghetto Museum, the Museum of the History of Polish Jews in Warsaw, Post Bellum online electronic collection of oral historical interviews, and witness accounts. The validity of the presented conclusions is ensured by comparing data from several sources. The most common infections in Theresienstadt children were enteritis, scarlet fever, infectious jaundice, measles, mumps, rubella, varicella, black cough, pneumonia, otitis media, and typhoid fever. Most of these infections had entirely atypical symptomatology or complications. Children were hospitalized in children's hospitals, in children's rooms of hospitals for adults and infirmaries in children's homes. Albeit diagnostic methods had a high standard, options of treatment were very limited. The most common treatments included bed rest, diet and cold compress. Occasionally, chemotherapeutic agents (e.g. a sulphonamide drug Prontosil) and Aspirin were available. The anti-epidemic measures in the ghetto focused on hygiene, enhancing children's immunity, vaccination and pest control.

[Possibilities of improvement of anti-epidemic events at forensic medical institution on the basis of quality management approaches]. / Vozmozhnosti sovershenstvovaniya protivoepidemicheskikh meropriyatii v byuro sudebno-meditsinskoi ekspertizy na osnove podkhodov menedzhmenta kachestva.

The article shows the experience of the Republican Bureau of Forensic Medical Expertise of the Ministry of Health of Tatarstan Republic in organizing and ensuring anti-epidemic measures using a quality management system. The comprehensive implementation of anti-epidemic measures in the expert institution dictates the need for regulation of the main provisions by internal documents (standard operative procedures), built on the basis of existing regulatory legal acts. The method of quality management system based on the Shekhard-Deming cycle was applied in practical activities, a process-based approach was used to organize work in organization. The proposed standard operative procedures, together with a model for managing the activities of an epidemiologist, showed high efficiency and allow improving the process of managing epidemiological risks.

In-vivo interspecies transmission of carbapenemase KPC in a long-term treated female patient.

The increasing incidence of multiresistant bacterial strains is currently a serious health concern. These pathogens are often the cause of nosocomial infections with limited treatment options and high fatality rates. A case report is presented of an uncommon detection of four different species (Citrobacter freundii, Klebsiella pneumoniae, Escherichia coli, and Morganella morganii) producing the same type of carbapenemase, KPC-2, in a female patient during her complicated long-term hospital stay. Resistance was probably spread to other species by horizontal transmission of plasmids carrying the blaKPC-2 genes. The implementation of strict anti-epidemic measures prevented further spread of these carbapenem-resistant bacteria.

Problematics of neurosurgical service during the COVID-19 pandemic in Slovenia.

The novel coronavirus disease 2019 (COVID-19) is an ongoing disease caused by severe acute respiratory syndrome coronavirus-2 that still poses an important and urgent threat to global health. In Slovenia, the epidemic was declared on March 12th, 2020, and since then COVID-19 has had a great impact on our health system. The field of neurosurgery in particular has been experiencing difficulties in both elective and emergency service. In this article, we described epidemiologic protocols and the effect that the COVID-19 pandemic had on the surgical practice and workflow of the Department of Neurosurgery at the University Medical Centre Ljubljana. We analyzed and compared the number of elective and emergency neurosurgical procedures in a 2-year period before and during the pandemic. We recorded a drop in cases mostly on account of elective procedures whilst emergency service remained relatively unaffected.

[COVID-19 immunizations in occupational medicine]. / Szczepienia przeciwko COVID-19 w medycynie pracy.

This article discusses issues related to exposure to SARS-CoV-2 in the work environment and employee's vaccination against COVID-19. The new SARS-CoV-2 coronavirus identified as the etiologic agent of COVID-19 prompted the World Health Organization (WHO) to declare a pandemic in March 2020. The droplet route transmits the virus. Therefore, health care workers in contact with sick people and anyone employed in direct contact with large numbers of people are particularly vulnerable to infection. The introduction of COVID-19 vaccination removes the need for quarantine, reduces the risk of disease, limits transmission within the workplace, and reduces sickness absence. The role of the occupational health services is to promote vaccination against COVID-19 by providing reliable information on the safety and efficacy of immunization and organizing and carrying out vaccination in workplaces. Med Pr. 2021;72(6):701-10.

El coronel Gustavo Pérez Abreu, precursor de la lucha antiepidémica en la República en Armas / Colonel Gustavo Pérez Abreu, forerunner of the epidemic fight in the Republic in Arms

RESUMEN La participación de los médicos en las guerras por la independencia de Cuba en el siglo XIX, constituye una apreciable fuente de experiencias para la medicina militar. Los valores patrióticos que los caracterizaron, son paradigmas para el trabajo educativo en la formación de las nuevas generaciones de médicos militares. Los médicos del Ejército Libertador son reconocidos por el ejercicio profesional en difíciles condiciones de campaña, ser valerosos combatientes y avezados jefes militares. Entre los que participaron en la heroica gesta independentista del 1895, se destacó el doctor Gustavo Pérez Abreu, un precursor del enfrentamiento a las enfermedades infecciosas que afectaron a las tropas insurrectas. El objetivo del presente trabajo es evocar su labor como miembro de la sanidad militar y destacar su importancia como paradigma para nuevas generaciones de médicos militares. Este notable médico prestó servicios en el Estado Mayor del general Máximo Gómez Báez y fue su médico personal. Cumplió misiones en el aseguramiento de acciones combativas dirigidas por el General en Jefe. Fundó y organizó hospitales de campaña para la atención de combatientes. Al finalizar la guerra, editó su diario de campaña con el título En la guerra con Máximo Gómez, un documento testimonial y contenido patriótico, con valor didáctico para conocer mejor la historia de la lucha de los cubanos por la independencia y el desempeño de los médicos y la Sanidad Militar del Ejército Libertador.

ABSTRACT The participation of doctors in the wars for the independence of Cuba in the nineteenth century is an important source of experience in military medicine. The patriotic values that characterized them are paradigms for educational work in the formation of new generations of military doctors. The physicians of the Cuban Liberator Army are recognized for practicing under difficult conditions, being courageous combatants and skilled military leaders. Among those who participated in the heroic independence, war in 1895 was Doctor Gustavo Pérez Abreu. He is precursor to the fight against infectious diseases that affected the troops. The aim of this paper is to evoke his work as a member of the military health service and to highlight his importance as a paradigm for new generations of military doctors. The synthetic historiographies and analytical method were used. This remarkable doctor served on the General Staff of Chief General Máximo Gómez Báez and was his personal physician too. He carried out missions to ensure combat actions led by the General in Chief. He also founded and organized field hospitals for the care of combatants. At the end of the war, he edited his campaign diary. It was one testimonial and patriotic document. In addition, it great has value to understand the history of the struggle of Cubans for the independence and performance of doctors and the Military Health of the Cuban Liberator Army. In this article is exalted his magnificent service to the homeland.