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1.
Ann Intern Med ; 175(9): 1240-1249, 2022 09.
Статья в английский | MEDLINE | ID: covidwho-2203115

Реферат

BACKGROUND: Centers for Disease Control and Prevention (CDC) defines low, medium, and high "COVID-19 community levels" to guide interventions, but associated mortality rates have not been reported. OBJECTIVE: To evaluate the diagnostic performance of CDC COVID-19 community level metrics as predictors of elevated community mortality risk. DESIGN: Time series analysis over the period of 30 May 2021 through 4 June 2022. SETTING: U.S. states and counties. PARTICIPANTS: U.S. population. MEASUREMENTS: CDC "COVID-19 community level" metrics based on hospital admissions, bed occupancy, and reported cases; reported COVID-19 deaths; and sensitivity, specificity, and predictive values for CDC and alternative metrics. RESULTS: Mean and median weekly mortality rates per 100 000 population after onset of high COVID-19 community level 3 weeks prior were, respectively, 2.6 and 2.4 (interquartile range [IQR], 1.7 to 3.1) across 90 high episodes in states and 4.3 and 2.1 (IQR, 0 to 5.4) across 7987 high episodes in counties. In 85 of 90 (94%) episodes in states and 4801 of 7987 (60%) episodes in counties, lagged weekly mortality after onset exceeded 0.9 per 100 000 population, and in 57 of 90 (63%) episodes in states and 4018 of 7987 (50%) episodes in counties, lagged weekly mortality after onset exceeded 2.1 per 100 000, which is equivalent to approximately 1000 daily deaths in the national population. Alternative metrics based on lower hospital admissions or case thresholds were associated with lower mortality and had higher sensitivity and negative predictive value for elevated mortality, but the CDC metrics had higher specificity and positive predictive value. Ratios between cases, hospitalizations, and deaths have varied substantially over time. LIMITATIONS: Aggregate mortality does not account for nonfatal outcomes or disparities. Continuing evolution of viral variants, immunity, clinical interventions, and public health mitigation strategies complicate prediction for future waves. CONCLUSION: Designing metrics for public health decision making involves tradeoffs between identifying early signals for action and avoiding undue restrictions when risks are modest. Explicit frameworks for evaluating surveillance metrics can improve transparency and decision support. PRIMARY FUNDING SOURCE: Council of State and Territorial Epidemiologists.


Тема - темы
COVID-19 , Centers for Disease Control and Prevention, U.S. , Hospitalization , Humans , Public Health , United States/epidemiology
2.
Bull World Health Organ ; 100(6): 366-374, 2022 Jun 01.
Статья в английский | MEDLINE | ID: covidwho-2198263

Реферат

Objective: To assess the stability of improvements in global respiratory virus surveillance in countries supported by the United States Centers for Disease Control and Prevention (CDC) after reductions in CDC funding and with the stress of the coronavirus disease 2019 (COVID-19) pandemic. Methods: We assessed whether national influenza surveillance systems of CDC-funded countries: (i) continued to analyse as many specimens between 2013 and 2021; (ii) participated in activities of the World Health Organization's (WHO) Global Influenza Surveillance and Response System; (iii) tested enough specimens to detect rare events or signals of unusual activity; and (iv) demonstrated stability before and during the COVID-19 pandemic. We used CDC budget records and data from the WHO Global Influenza Surveillance and Response System. Findings: While CDC reduced per-country influenza funding by about 75% over 10 years, the number of specimens tested annually remained stable (mean 2261). Reporting varied substantially by country and transmission zone. Countries funded by CDC accounted for 71% (range 61-75%) of specimens included in WHO consultations on the composition of influenza virus vaccines. In 2019, only eight of the 17 transmission zones sent enough specimens to WHO collaborating centres before the vaccine composition meeting to reliably identify antigenic variants. Conclusion: Great progress has been made in the global understanding of influenza trends and seasonality. To optimize surveillance to identify atypical influenza viruses, and to integrate molecular testing, sequencing and reporting of severe acute respiratory syndrome coronavirus 2 into existing systems, funding must continue to support these efforts.


Тема - темы
COVID-19 , Influenza Vaccines , Influenza, Human , COVID-19/epidemiology , COVID-19/prevention & control , Centers for Disease Control and Prevention, U.S. , Humans , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Pandemics/prevention & control , Population Surveillance , United States/epidemiology
4.
MMWR Morb Mortal Wkly Rep ; 71(17): 592-596, 2022 Apr 29.
Статья в английский | MEDLINE | ID: covidwho-2204198

Реферат

On August 29, 2021, the United States government oversaw the emergent establishment of Operation Allies Welcome (OAW), led by the U.S. Department of Homeland Security (DHS) and implemented by the U.S. Department of Defense (DoD) and U.S. Department of State (DoS), to safely resettle U.S. citizens and Afghan nationals from Afghanistan to the United States. Evacuees were temporarily housed at several overseas locations in Europe and Asia* before being transported via military and charter flights through two U.S. international airports, and onward to eight U.S. military bases,† with hotel A used for isolation and quarantine of persons with or exposed to certain infectious diseases.§ On August 30, CDC issued an Epi-X notice encouraging public health officials to maintain vigilance for measles among Afghan evacuees because of an ongoing measles outbreak in Afghanistan (25,988 clinical cases reported nationwide during January-November 2021) (1) and low routine measles vaccination coverage (66% and 43% for the first and second doses, respectively, in 2020) (2).


Тема - темы
Communicable Diseases , Measles , Communicable Diseases/epidemiology , Disease Outbreaks/prevention & control , Humans , Measles/epidemiology , Measles/prevention & control , Public Health , United States/epidemiology , Vaccination
5.
JMIR Public Health Surveill ; 7(11): e32639, 2021 11 01.
Статья в английский | MEDLINE | ID: covidwho-2197980

Реферат

BACKGROUND: The Eastern Mediterranean Region (EMR) hosts some of the world's worst humanitarian and health crises. The implementation of health surveillance in this region has faced multiple constraints. New and novel approaches in surveillance are in a constant state of high and immediate demand. Identifying the existing literature on surveillance helps foster an understanding of scientific development and thus potentially supports future development directions. OBJECTIVE: This study aims to illustrate the scientific production, quantify the scholarly impact, and highlight the characteristics of publications on public health surveillance in the EMR over the past decade. METHODS: We performed a Scopus search using keywords related to public health surveillance or its disciplines, cross-referenced with EMR countries, from 2011 to July 2021. Data were exported and analyzed using Microsoft Excel and Visualization of Similarities Viewer. Quality of journals was determined using SCImago Journal Rank and CiteScore. RESULTS: We retrieved 1987 documents, of which 1927 (96.98%) were articles or reviews. There has been an incremental increase in the number of publications (exponential growth, R2=0.80) over the past decade. Publications were mostly affiliated with Iran (501/1987, 25.21%), the United States (468/1987, 23.55%), Pakistan (243/1987, 12.23%), Egypt (224/1987, 11.27%), and Saudi Arabia (209/1987, 10.52%). However, Iran only had links with 40 other countries (total link strength 164), and the biggest collaborator from the EMR was Egypt, with 67 links (total link strength 402). Within the other EMR countries, only Morocco, Lebanon, and Jordan produced ≥79 publications in the 10-year period. Most publications (1551/1987, 78.06%) were affiliated with EMR universities. Most journals were categorized as medical journals, and the highest number of articles were published in the Eastern Mediterranean Health Journal (SCImago Journal Rank 0.442; CiteScore 1.5). Retrieved documents had an average of 18.4 (SD 125.5) citations per document and an h-index of 66. The top-3 most cited documents were from the Global Burden of Diseases study. We found 70 high-frequency terms, occurring ≥10 times in author keywords, connected in 3 clusters. COVID-19, SARS-CoV-2, and pandemic represented the most recent 2020 cluster. CONCLUSIONS: This is the first research study to quantify the published literature on public health surveillance and its disciplines in the EMR. Research productivity has steadily increased over the past decade, and Iran has been the leading country publishing relevant research. Recurrent recent surveillance themes included COVID-19 and SARS-CoV-2. This study also sheds light on the gaps in surveillance research in the EMR, including inadequate publications on noncommunicable diseases and injury-related surveillance.


Тема - темы
COVID-19 , Public Health Surveillance , Bibliometrics , Humans , Mediterranean Region , SARS-CoV-2 , United States
6.
JMIR Public Health Surveill ; 7(6): e27917, 2021 06 02.
Статья в английский | MEDLINE | ID: covidwho-2197909

Реферат

BACKGROUND: The United States of America has the highest global number of COVID-19 cases and deaths, which may be due in part to delays and inconsistencies in implementing public health and social measures (PHSMs). OBJECTIVE: In this descriptive analysis, we analyzed the epidemiological evidence for the impact of PHSMs on COVID-19 transmission in the United States and compared these data to those for 10 other countries of varying income levels, population sizes, and geographies. METHODS: We compared PHSM implementation timing and stringency against COVID-19 daily case counts in the United States and against those in Canada, China, Ethiopia, Japan, Kazakhstan, New Zealand, Singapore, South Korea, Vietnam, and Zimbabwe from January 1 to November 25, 2020. We descriptively analyzed the impact of border closures, contact tracing, household confinement, mandated face masks, quarantine and isolation, school closures, limited gatherings, and states of emergency on COVID-19 case counts. We also compared the relationship between global socioeconomic indicators and national pandemic trajectories across the 11 countries. PHSMs and case count data were derived from various surveillance systems, including the Health Intervention Tracking for COVID-19 database, the World Health Organization PHSM database, and the European Centre for Disease Prevention and Control. RESULTS: Implementing a specific package of 4 PHSMs (quarantine and isolation, school closures, household confinement, and the limiting of social gatherings) early and stringently was observed to coincide with lower case counts and transmission durations in Vietnam, Zimbabwe, New Zealand, South Korea, Ethiopia, and Kazakhstan. In contrast, the United States implemented few PHSMs stringently or early and did not use this successful package. Across the 11 countries, national income positively correlated (r=0.624) with cumulative COVID-19 incidence. CONCLUSIONS: Our findings suggest that early implementation, consistent execution, adequate duration, and high adherence to PHSMs represent key factors of reducing the spread of COVID-19. Although national income may be related to COVID-19 progression, a country's wealth appears to be less important in controlling the pandemic and more important in taking rapid, centralized, and consistent public health action.


Тема - темы
COVID-19/prevention & control , Global Health/statistics & numerical data , Public Health/legislation & jurisprudence , COVID-19/epidemiology , COVID-19/transmission , Databases, Factual , Humans , Physical Distancing , Quarantine , Schools/organization & administration , United States/epidemiology , Workplace/organization & administration
7.
JMIR Public Health Surveill ; 7(3): e26719, 2021 03 24.
Статья в английский | MEDLINE | ID: covidwho-2197901

Реферат

BACKGROUND: Patient travel history can be crucial in evaluating evolving infectious disease events. Such information can be challenging to acquire in electronic health records, as it is often available only in unstructured text. OBJECTIVE: This study aims to assess the feasibility of annotating and automatically extracting travel history mentions from unstructured clinical documents in the Department of Veterans Affairs across disparate health care facilities and among millions of patients. Information about travel exposure augments existing surveillance applications for increased preparedness in responding quickly to public health threats. METHODS: Clinical documents related to arboviral disease were annotated following selection using a semiautomated bootstrapping process. Using annotated instances as training data, models were developed to extract from unstructured clinical text any mention of affirmed travel locations outside of the continental United States. Automated text processing models were evaluated, involving machine learning and neural language models for extraction accuracy. RESULTS: Among 4584 annotated instances, 2659 (58%) contained an affirmed mention of travel history, while 347 (7.6%) were negated. Interannotator agreement resulted in a document-level Cohen kappa of 0.776. Automated text processing accuracy (F1 85.6, 95% CI 82.5-87.9) and computational burden were acceptable such that the system can provide a rapid screen for public health events. CONCLUSIONS: Automated extraction of patient travel history from clinical documents is feasible for enhanced passive surveillance public health systems. Without such a system, it would usually be necessary to manually review charts to identify recent travel or lack of travel, use an electronic health record that enforces travel history documentation, or ignore this potential source of information altogether. The development of this tool was initially motivated by emergent arboviral diseases. More recently, this system was used in the early phases of response to COVID-19 in the United States, although its utility was limited to a relatively brief window due to the rapid domestic spread of the virus. Such systems may aid future efforts to prevent and contain the spread of infectious diseases.


Тема - темы
Communicable Diseases, Emerging/diagnosis , Electronic Health Records , Information Storage and Retrieval/methods , Public Health Surveillance/methods , Travel/statistics & numerical data , Algorithms , COVID-19/epidemiology , Communicable Diseases, Emerging/epidemiology , Feasibility Studies , Female , Humans , Machine Learning , Male , Middle Aged , Natural Language Processing , Reproducibility of Results , United States/epidemiology
8.
JMIR Public Health Surveill ; 7(12): e26644, 2021 12 21.
Статья в английский | MEDLINE | ID: covidwho-2197900

Реферат

BACKGROUND: Due to the COVID-19 pandemic, health information related to COVID-19 has spread across news media worldwide. Google is among the most used internet search engines, and the Google Trends tool can reflect how the public seeks COVID-19-related health information during the pandemic. OBJECTIVE: The aim of this study was to understand health communication through Google Trends and news coverage and to explore their relationship with prevention and control of COVID-19 at the early epidemic stage. METHODS: To achieve the study objectives, we analyzed the public's information-seeking behaviors on Google and news media coverage on COVID-19. We collected data on COVID-19 news coverage and Google search queries from eight countries (ie, the United States, the United Kingdom, Canada, Singapore, Ireland, Australia, South Africa, and New Zealand) between January 1 and April 29, 2020. We depicted the characteristics of the COVID-19 news coverage trends over time, as well as the search query trends for the topics of COVID-19-related "diseases," "treatments and medical resources," "symptoms and signs," and "public measures." The search query trends provided the relative search volume (RSV) as an indicator to represent the popularity of a specific search term in a specific geographic area over time. Also, time-lag correlation analysis was used to further explore the relationship between search terms trends and the number of new daily cases, as well as the relationship between search terms trends and news coverage. RESULTS: Across all search trends in eight countries, almost all search peaks appeared between March and April 2020, and declined in April 2020. Regarding COVID-19-related "diseases," in most countries, the RSV of the term "coronavirus" increased earlier than that of "covid-19"; however, around April 2020, the search volume of the term "covid-19" surpassed that of "coronavirus." Regarding the topic "treatments and medical resources," the most and least searched terms were "mask" and "ventilator," respectively. Regarding the topic "symptoms and signs," "fever" and "cough" were the most searched terms. The RSV for the term "lockdown" was significantly higher than that for "social distancing" under the topic "public health measures." In addition, when combining search trends with news coverage, there were three main patterns: (1) the pattern for Singapore, (2) the pattern for the United States, and (3) the pattern for the other countries. In the time-lag correlation analysis between the RSV for the topic "treatments and medical resources" and the number of new daily cases, the RSV for all countries except Singapore was positively correlated with new daily cases, with a maximum correlation of 0.8 for the United States. In addition, in the time-lag correlation analysis between the overall RSV for the topic "diseases" and the number of daily news items, the overall RSV was positively correlated with the number of daily news items, the maximum correlation coefficient was more than 0.8, and the search behavior occurred 0 to 17 days earlier than the news coverage. CONCLUSIONS: Our findings revealed public interest in masks, disease control, and public measures, and revealed the potential value of Google Trends in the face of the emergence of new infectious diseases. Also, Google Trends combined with news media can achieve more efficient health communication. Therefore, both news media and Google Trends can contribute to the early prevention and control of epidemics.


Тема - темы
COVID-19 , Health Communication , Humans , Information Seeking Behavior , Pandemics , SARS-CoV-2 , Search Engine , United States/epidemiology
9.
JMIR Public Health Surveill ; 7(3): e25859, 2021 03 26.
Статья в английский | MEDLINE | ID: covidwho-2197891

Реферат

BACKGROUND: The COVID-19 pandemic has drastically changed life in the United States, as the country has recorded over 23 million cases and 383,000 deaths to date. In the leadup to widespread vaccine deployment, testing and surveillance are critical for detecting and stopping possible routes of transmission. Contact tracing has become an important surveillance measure to control COVID-19 in the United States, and mobile health interventions have found increased prominence in this space. OBJECTIVE: The aim of this study was to investigate the use and usability of MyCOVIDKey, a mobile-based web app to assist COVID-19 contact tracing efforts, during the 6-week pilot period. METHODS: A 6-week study was conducted on the Vanderbilt University campus in Nashville, Tennessee. The study participants, consisting primarily of graduate students, postdoctoral researchers, and faculty in the Chemistry Department at Vanderbilt University, were asked to use the MyCOVIDKey web app during the course of the study period. Paradata were collected as users engaged with the MyCOVIDKey web app. At the end of the study, all participants were asked to report on their user experience in a survey, and the results were analyzed in the context of the user paradata. RESULTS: During the pilot period, 45 users enrolled in MyCOVIDKey. An analysis of their enrollment suggests that initial recruiting efforts were effective; however, participant recruitment and engagement efforts at the midpoint of the study were less effective. App use paralleled the number of users, indicating that incentives were useful for recruiting new users to sign up but did not result in users attempting to artificially inflate their use as a result of prize offers. Times to completion of key tasks were low, indicating that the main features of the app could be used quickly. Of the 45 users, 30 provided feedback through a postpilot survey, with 26 (58%) completing it in its entirety. The MyCOVIDKey app as a whole was rated 70.0 on the System Usability Scale, indicating that it performed above the accepted threshold for usability. When the key-in and self-assessment features were examined on their own, it was found that they individually crossed the same thresholds for acceptable usability but that the key-in feature had a higher margin for improvement. CONCLUSIONS: The MyCOVIDKey app was found overall to be a useful tool for COVID-19 contact tracing in a university setting. Most users suggested simple-to-implement improvements, such as replacing the web app framework with a native app format or changing the placement of the scanner within the app workflow. After these updates, this tool could be readily deployed and easily adapted to other settings across the country. The need for digital contact tracing tools is becoming increasingly apparent, particularly as COVID-19 case numbers continue to increase while more businesses begin to reopen.


Тема - темы
COVID-19/prevention & control , Contact Tracing/methods , Mobile Applications , Adult , COVID-19/epidemiology , Data Analysis , Female , Humans , Male , Middle Aged , Pilot Projects , Surveys and Questionnaires , United States/epidemiology , Young Adult
10.
JMIR Public Health Surveill ; 7(3): e21606, 2021 03 18.
Статья в английский | MEDLINE | ID: covidwho-2197869

Реферат

BACKGROUND: Previous studies on the impact of social distancing on COVID-19 mortality in the United States have predominantly examined this relationship at the national level and have not separated COVID-19 deaths in nursing homes from total COVID-19 deaths. This approach may obscure differences in social distancing behaviors by county in addition to the actual effectiveness of social distancing in preventing COVID-19 deaths. OBJECTIVE: This study aimed to determine the influence of county-level social distancing behavior on COVID-19 mortality (deaths per 100,000 people) across US counties over the period of the implementation of stay-at-home orders in most US states (March-May 2020). METHODS: Using social distancing data from tracked mobile phones in all US counties, we estimated the relationship between social distancing (average proportion of mobile phone usage outside of home between March and May 2020) and COVID-19 mortality (when the state in which the county is located reported its first confirmed case of COVID-19 and up to May 31, 2020) with a mixed-effects negative binomial model while distinguishing COVID-19 deaths in nursing homes from total COVID-19 deaths and accounting for social distancing- and COVID-19-related factors (including the period between the report of the first confirmed case of COVID-19 and May 31, 2020; population density; social vulnerability; and hospital resource availability). Results from the mixed-effects negative binomial model were then used to generate marginal effects at the mean, which helped separate the influence of social distancing on COVID-19 deaths from other covariates while calculating COVID-19 deaths per 100,000 people. RESULTS: We observed that a 1% increase in average mobile phone usage outside of home between March and May 2020 led to a significant increase in COVID-19 mortality by a factor of 1.18 (P<.001), while every 1% increase in the average proportion of mobile phone usage outside of home in February 2020 was found to significantly decrease COVID-19 mortality by a factor of 0.90 (P<.001). CONCLUSIONS: As stay-at-home orders have been lifted in many US states, continued adherence to other social distancing measures, such as avoiding large gatherings and maintaining physical distance in public, are key to preventing additional COVID-19 deaths in counties across the country.


Тема - темы
COVID-19/mortality , COVID-19/prevention & control , Physical Distancing , Cross-Sectional Studies , Humans , Models, Statistical , United States/epidemiology
11.
J Health Polit Policy Law ; 47(2): 159-200, 2022 04 01.
Статья в английский | MEDLINE | ID: covidwho-2196726

Реферат

Data on the health and social determinants for Native Hawaiians and Pacific Islanders (NHPIs) in the United States are hidden, because data are often not collected or are reported in aggregate with other racial/ethnic groups despite decades of calls to disaggregate NHPI data. As a form of structural racism, data omissions contribute to systemic problems such as inability to advocate, lack of resources, and limitations on political power. The authors conducted a data audit to determine how US federal agencies are collecting and reporting disaggregated NHPI data. Using the COVID-19 pandemic as a case study, they reviewed how states are reporting NHPI cases and deaths. They then used California's neighborhood equity metric-the California Healthy Places Index (HPI)-to calculate the extent of NHPI underrepresentation in communities targeted for COVID-19 resources in that state. Their analysis shows that while collection and reporting of NHPI data nationally has improved, federal data gaps remain. States are vastly underreporting: more than half of states are not reporting NHPI COVID-19 case and death data. The HPI, used to inform political decisions about allocation of resources to combat COVID-19 in at-risk neighborhoods, underrepresents NHPIs. The authors make recommendations for improving NHPI data equity to achieve health equity and social justice.


Тема - темы
COVID-19 , COVID-19/epidemiology , Humans , Pandemics , Research Design , United States
12.
Health Educ Behav ; 49(1): 11-16, 2022 02.
Статья в английский | MEDLINE | ID: covidwho-2195116

Реферат

Social and health inequities among communities of color are deeply embedded in the United States and were exacerbated by the COVID-19 pandemic. Community-based participatory research (CBPR) is a powerful approach to advance health equity. However, emergencies both as global as a pandemic or as local as a forest fire have the power to interrupt research programs and weaken community relationships. Drawing from Public Health Critical Race Praxis (PHCRP), as well as our research experience during the pandemic, this article proposes an expansion of prior CBPR principles with an emphasis on advocacy and storytelling, community investment, and flexibility. The article summarizes key principles of CBPR and PHCRP, contextualizes their relevance in COVID-19, and outlines a practical vision for crisis-resilient research through deeper engagement with antiracism scholarship. Structural barriers remain an issue, so policy changes to funding and research institutions are recommended, as well, to truly advance health equity.


Тема - темы
COVID-19 , Health Equity , Community-Based Participatory Research , Humans , Pandemics , SARS-CoV-2 , United States/epidemiology
13.
Cancer Epidemiol Biomarkers Prev ; 30(10): 1884-1894, 2021 10.
Статья в английский | MEDLINE | ID: covidwho-2194255

Реферат

BACKGROUND: We described the demographics, cancer subtypes, comorbidities, and outcomes of patients with a history of cancer and coronavirus disease 2019 (COVID-19). Second, we compared patients hospitalized with COVID-19 to patients diagnosed with COVID-19 and patients hospitalized with influenza. METHODS: We conducted a cohort study using eight routinely collected health care databases from Spain and the United States, standardized to the Observational Medical Outcome Partnership common data model. Three cohorts of patients with a history of cancer were included: (i) diagnosed with COVID-19, (ii) hospitalized with COVID-19, and (iii) hospitalized with influenza in 2017 to 2018. Patients were followed from index date to 30 days or death. We reported demographics, cancer subtypes, comorbidities, and 30-day outcomes. RESULTS: We included 366,050 and 119,597 patients diagnosed and hospitalized with COVID-19, respectively. Prostate and breast cancers were the most frequent cancers (range: 5%-18% and 1%-14% in the diagnosed cohort, respectively). Hematologic malignancies were also frequent, with non-Hodgkin's lymphoma being among the five most common cancer subtypes in the diagnosed cohort. Overall, patients were aged above 65 years and had multiple comorbidities. Occurrence of death ranged from 2% to 14% and from 6% to 26% in the diagnosed and hospitalized COVID-19 cohorts, respectively. Patients hospitalized with influenza (n = 67,743) had a similar distribution of cancer subtypes, sex, age, and comorbidities but lower occurrence of adverse events. CONCLUSIONS: Patients with a history of cancer and COVID-19 had multiple comorbidities and a high occurrence of COVID-19-related events. Hematologic malignancies were frequent. IMPACT: This study provides epidemiologic characteristics that can inform clinical care and etiologic studies.


Тема - темы
COVID-19/mortality , Neoplasms/epidemiology , Outcome Assessment, Health Care/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Child , Cohort Studies , Comorbidity , Databases, Factual , Female , Hospitalization/statistics & numerical data , Humans , Influenza, Human/epidemiology , Male , Middle Aged , Pandemics , Prevalence , Risk Factors , SARS-CoV-2 , Spain/epidemiology , United States/epidemiology , Young Adult
14.
Medicine (Baltimore) ; 100(40): e27423, 2021 Oct 08.
Статья в английский | MEDLINE | ID: covidwho-2191078

Реферат

ABSTRACT: The COVID-19 pandemic disrupted almost all sectors of academic training and research, but the impact on human immunodeficiency virus (HIV) research mentoring has yet to be documented. We present the perspectives of diverse, experienced mentors in a range of HIV research disciplines on the impact of COVID-19 on mentoring the next generation of HIV researchers.In November to December, 2020, we used an online data collection platform to cross-sectionally query previously-trained HIV mentors on the challenges related to mentoring during the pandemic, surprising/positive aspects of mentoring in that context, and recommendations for other mentors. Data were coded and analyzed following a thematic analysis approach.Respondents (180 of 225 mentors invited [80% response]) reported challenges related to relationship building/maintenance, disruptions in mentees' training and research progress, and mentee and mentor distress, with particular concerns regarding mentees who are parents or from underrepresented minority backgrounds. Positive/surprising aspects included logistical ease of remote mentoring, the relationship-edifying result of the shared pandemic experience, mentee resilience and gratitude, and increased enjoyment of mentoring. Recommendations included practical tips, encouragement for patience and persistence, and prioritizing supporting mentees' and one's own mental well-being.Findings revealed gaps in HIV mentors' competencies, including the effective use of remote mentoring tools, how to work with mentees in times of distress, and the prioritization of mentor well-being. Mentors are in a unique position to identify and potentially address factors that may lead to mentees leaving their fields, especially parents and those from underrepresented backgrounds. We discuss implications beyond the COVID-19 pandemic.


Тема - темы
COVID-19/epidemiology , HIV Infections/epidemiology , Mentoring/organization & administration , Research Personnel/education , Cross-Sectional Studies , Education, Distance , Female , Humans , Male , Pandemics , Professional Competence , Qualitative Research , SARS-CoV-2 , Stress, Psychological/epidemiology , United States/epidemiology
15.
Lancet Digit Health ; 3(9): e577-e586, 2021 09.
Статья в английский | MEDLINE | ID: covidwho-2184865

Реферат

BACKGROUND: Multiple voluntary surveillance platforms were developed across the world in response to the COVID-19 pandemic, providing a real-time understanding of population-based COVID-19 epidemiology. During this time, testing criteria broadened and health-care policies matured. We aimed to test whether there were consistent associations of symptoms with SARS-CoV-2 test status across three surveillance platforms in three countries (two platforms per country), during periods of testing and policy changes. METHODS: For this observational study, we used data of observations from three volunteer COVID-19 digital surveillance platforms (Carnegie Mellon University and University of Maryland Facebook COVID-19 Symptom Survey, ZOE COVID Symptom Study app, and the Corona Israel study) targeting communities in three countries (Israel, the UK, and the USA; two platforms per country). The study population included adult respondents (age 18-100 years at baseline) who were not health-care workers. We did logistic regression of self-reported symptoms on self-reported SARS-CoV-2 test status (positive or negative), adjusted for age and sex, in each of the study cohorts. We compared odds ratios (ORs) across platforms and countries, and we did meta-analyses assuming a random effects model. We also evaluated testing policy changes, COVID-19 incidence, and time scales of duration of symptoms and symptom-to-test time. FINDINGS: Between April 1 and July 31, 2020, 514 459 tests from over 10 million respondents were recorded in the six surveillance platform datasets. Anosmia-ageusia was the strongest, most consistent symptom associated with a positive COVID-19 test (robust aggregated rank one, meta-analysed random effects OR 16·96, 95% CI 13·13-21·92). Fever (rank two, 6·45, 4·25-9·81), shortness of breath (rank three, 4·69, 3·14-7·01), and cough (rank four, 4·29, 3·13-5·88) were also highly associated with test positivity. The association of symptoms with test status varied by duration of illness, timing of the test, and broader test criteria, as well as over time, by country, and by platform. INTERPRETATION: The strong association of anosmia-ageusia with self-reported positive SARS-CoV-2 test was consistently observed, supporting its validity as a reliable COVID-19 signal, regardless of the participatory surveillance platform, country, phase of illness, or testing policy. These findings show that associations between COVID-19 symptoms and test positivity ranked similarly in a wide range of scenarios. Anosmia, fever, and respiratory symptoms consistently had the strongest effect estimates and were the most appropriate empirical signals for symptom-based public health surveillance in areas with insufficient testing or benchmarking capacity. Collaborative syndromic surveillance could enhance real-time epidemiological investigations and public health utility globally. FUNDING: National Institutes of Health, National Institute for Health Research, Alzheimer's Society, Wellcome Trust, and Massachusetts Consortium on Pathogen Readiness.


Тема - темы
Ageusia , Anosmia , COVID-19 , Cough , Dyspnea , Fever , Population Surveillance/methods , Adolescent , Adult , Aged , Aged, 80 and over , Ageusia/epidemiology , Ageusia/etiology , Anosmia/epidemiology , Anosmia/etiology , COVID-19/complications , COVID-19/epidemiology , COVID-19/virology , Cough/epidemiology , Cough/etiology , Digital Technology , Dyspnea/epidemiology , Dyspnea/etiology , Female , Fever/epidemiology , Fever/etiology , Humans , Israel/epidemiology , Male , Middle Aged , Odds Ratio , Pandemics , SARS-CoV-2 , United Kingdom/epidemiology , United States/epidemiology , Young Adult
16.
J Gen Intern Med ; 37(3): 686-688, 2022 02.
Статья в английский | MEDLINE | ID: covidwho-2174889
17.
J Law Med Ethics ; 48(4_suppl): 9-10, 2020 12.
Статья в английский | MEDLINE | ID: covidwho-2194809
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