Simple mathematical model for predicting COVID-19 outbreaks in Japan based on epidemic waves with a cyclical trend.

BACKGROUND: Several models have been used to predict outbreaks during the COVID-19 pandemic, with limited success. We developed a simple mathematical model to accurately predict future epidemic waves. METHODS: We used data from the Ministry of Health, Labour and Welfare of Japan for newly confirmed COVID-19 cases. COVID-19 case data were summarized as weekly data, and epidemic waves were visualized and identified. The periodicity of COVID-19 in each prefecture of Japan was confirmed using time-series analysis and the autocorrelation coefficient, which was used to investigate the longer-term pattern of COVID-19 cases. Outcomes using the autocorrelation coefficient were visualized via a correlogram to capture the periodicity of the data. An algorithm for a simple prediction model of the seventh COVID-19 wave in Japan comprised three steps. Step 1: machine learning techniques were used to depict the regression lines for each epidemic wave, denoting the "rising trend line"; Step 2: an exponential function with good fit was identified from data of rising straight lines up to the sixth wave, and the timing of the rise of the seventh wave and speed of its spread were calculated; Step 3: a logistic function was created using the values calculated in Step 2 as coefficients to predict the seventh wave. The accuracy of the model in predicting the seventh wave was confirmed using data up to the sixth wave. RESULTS: Up to March 31, 2023, the correlation coefficient value was approximately 0.5, indicating significant periodicity. The spread of COVID-19 in Japan was repeated in a cycle of approximately 140 days. Although there was a slight lag in the starting and peak times in our predicted seventh wave compared with the actual epidemic, our developed prediction model had a fairly high degree of accuracy. CONCLUSION: Our newly developed prediction model based on the rising trend line could predict COVID-19 outbreaks up to a few months in advance with high accuracy. The findings of the present study warrant further investigation regarding application to emerging infectious diseases other than COVID-19 in which the epidemic wave has high periodicity.

Adaptations in the role of pharmacists under the conditions of the COVID-19 pandemic: a systematic review and meta-analysis.

BACKGROUND: Community pharmacists actively engage in managing the health of local residents, but the COVID-19 pandemic has necessitated rapid adaptations in practice activities. OBJECTIVES: We sought to identify the specific adaptations in practice and the expanded roles of community pharmacists in response to the COVID-19 pandemic. METHODS: We conducted a systematic review of published studies reporting the tasks of pharmacists in community pharmacies or who were involved in pharmacy practices addressing the pandemic. Two investigators independently searched PubMed (December 2019-January 2022) for eligible articles. We conducted a meta-analysis to measure the frequencies of practical activities by pharmacists in response to COVID-19. RESULTS: We identified 30 eligible studies. Meta-analysis of these studies found that the most commonly reported adaptation in pharmacist practice activities was modifying hygiene behaviors, including regular cleaning and disinfection (81.89%), followed by maintaining social distance from staff and clients (76.37%). Educating clients on COVID-19 was reported by 22 studies (72.54%). Telemedicine and home delivery services were provided to clients by 49.03 and 41.98% of pharmacists, respectively. CONCLUSIONS: The roles of community pharmacists in public health activities have adapted and expanded in response to COVID-19, notably by incorporating public health education activities.

Clinical characteristics and mortality risk among critically ill patients with COVID-19 owing to the B.1.617.2 (Delta) variant in Vietnam: A retrospective observational study.

BACKGROUND: SARS-CoV-2 Delta variant caused a large number of COVID-19 cases in many countries, including Vietnam. Understanding mortality risk factors is crucial for the clinical management of severe COVID-19. METHODS: We conducted a retrospective study at an intensive care center in Ho Chi Minh City that urgently built by Bach Mai Hospital during the COVID-19 outbreak in Vietnam, when the Delta variant predominated. Participants were laboratory-confirmed patients with SARS-CoV-2 infection, admitted in August 2021. Data on patients' demographic and clinical characteristics, radiographic and laboratory findings, treatment, and clinical time course were compared between survivors and non-survivors. Risk factors to mortality were assessed using logistic regression. RESULTS: Among 504 eligible COVID-19 patients, case fatality was 52.2%. Unvaccinated patients accounted for 61.2% of non-survivors and 43.6% of survivors (p < 0.001). The time from onset to hospital admission was 8 days in non-survivors and 7 days in survivors (p = 0.004). Among non-survivors, 90.2% developed acute respiratory distress syndrome (ARDS). Oxygen therapy was administered for all patients, but antiviral agent was given to 51.7% of non-survivors. 54.2% of non-survivors tested positive for the bacterial infection using blood culture. The risk factors for mortality were diabetes mellitus, respiration rate, oxygen saturation, vaccination status, time from onset to admission, and older age. CONCLUSIONS: Critical patients with COVID-19 owing to the Delta variant in Vietnam had delayed hospital admission, leading to ARDS and death. Early availability of vaccines and preventing bacterial infections are crucial for reducing mortality of COVID-19, especially in low- and middle-income countries.

Knowledge, Attitudes, and Practices Survey among Nursing Care Workers Involved in Caring for Older Adults during the Early Stage of the COVID-19 Pandemic in Japan.

BACKGROUND: As Japan undergoes population aging, nursing care workers play an important role in supporting older adults in the community, which has been particularly critical during COVID-19 pandemic. However, the knowledge, attitudes, and practices (KAP) among nursing care workers regarding COVID-19 have not been fully elucidated. METHODS: A self-administered questionnaire survey was conducted in June 2020 among 481 nursing care workers in the nursing care facilities in Aichi, Japan. We assessed COVID-19-related KAP scores of nursing care workers, and compared them by age, sex, and years of experience. RESULTS: A total of 481 nursing care workers responded to the survey. Out of a maximum of 10 points, the mean (standard deviations) knowledge, attitude, and practice scores were 6.86 (1.45), 7.11 (1.42), and 7.40 (1.89), respectively. Comparisons between the KAP scores revealed significantly higher knowledge scores among older workers (p < 0.001) and significantly higher knowledge scores (p = 0.002) and practice scores (p = 0.033) among workers with more than 20 years of working experience. CONCLUSIONS: The findings revealed that older age and a longer duration of experience were associated with higher COVID-19-related knowledge and practice scores. To better support older adults, it is essential to improve the education system for care workers and to provide environments for delivering necessary information rapidly.

Knowledge, attitudes, and practices regarding COVID-19 among pharmacists partnering with community residents: A national survey in Japan.

BACKGROUND: Community pharmacists play an important role in reducing COVID-19-related secondary health problems. However, the knowledge, attitudes, and practices (KAP) regarding COVID-19 among pharmacists in Japan have not yet been elucidated. METHODS: We conducted a web-based questionnaire survey among 1,137 pharmacists working in health support pharmacies (HSPs) in Japan. These pharmacists are responsible for providing health consultations to community residents. We assessed COVID-19-related KAP among pharmacists and compared the results for two age groups: ≤49 years and ≥50 years. We used multiple regression analysis to examine which factors influence KAP scores regarding COVID-19. RESULTS: From among the 2,141 HSPs in Japan, a total of 1,137 pharmacists, each representing a different HSP, responded to the survey. The results indicated that since the beginning of the COVID-19 pandemic, pharmacists have been providing consultations about COVID-19 to local residents, covering topics such as "Effective infection prevention methods" (60.6%) and "What the COVID-19 pandemic would be" (48.8%). Importantly, 73.5% of the pharmacists felt they "did not have enough information about COVID-19." The main information resources about COVID-19 were Internet (91.2%) and television (78.9%). Across all respondents, the mean knowledge score (4.17/10) was lower than the mean scores for attitudes (7.26/10) and practices (5.79/10). Multiple regression analysis showed that having enough information about COVID-19 was a factor strongly associated with total KAP scores (p<0.001; 95% confidence interval, -1.344 to -0.540). CONCLUSIONS: Pharmacists working in community pharmacies provide residents with information related to COVID-19. In this role as a health partner, these pharmacists need a way to strengthen and expand their knowledge, and moreover, their ability to support community residents. Learning more about the available academic and scientific information, as well as having access to accurate epidemiological information, can offer a means of reaching these goals.

Spatiotemporal distribution of COVID-19 during the first 7 months of the epidemic in Vietnam.

BACKGROUND: Understanding the spatiotemporal distribution of emerging infectious diseases is crucial for implementation of control measures. In the first 7 months from the occurrence of COVID-19 pandemic, Vietnam has documented comparatively few cases of COVID-19. Understanding the spatiotemporal distribution of these cases may contribute to development of global countermeasures. METHODS: We assessed the spatiotemporal distribution of COVID-19 from 23 January to 31 July 2020 in Vietnam. Data were collected from reports of the World Health Organization, the Vietnam Ministry of Health, and related websites. Temporal distribution was assessed via the transmission classification (local or quarantined cases). Geographical distribution was assessed via the number of cases in each province along with their timelines. The most likely disease clusters with elevated incidence were assessed via calculation of the relative risk (RR). RESULTS: Among 544 observed cases of COVID-19, the median age was 35 years, 54.8% were men, and 50.9% were diagnosed during quarantine. During the observation period, there were four phases: Phase 1, COVID-19 cases occurred sporadically in January and February 2020; Phase 2, an epidemic wave occurred from the 1st week of March to the middle of April (Wave 1); Phase 3, only quarantining cases were involved; and Phase 4, a second epidemic wave began on July 25th, 2020 (Wave 2). A spatial cluster in Phase 1 was detected in Vinh Phuc Province (RR, 38.052). In Phase 2, primary spatial clusters were identified in the areas of Hanoi and Ha Nam Province (RR, 6.357). In Phase 4, a spatial cluster was detected in Da Nang, a popular coastal tourist destination (RR, 70.401). CONCLUSIONS: Spatial disease clustering of COVID-19 in Vietnam was associated with large cities, tourist destinations, people's mobility, and the occurrence of nosocomial infections. Past experiences with outbreaks of emerging infectious diseases led to quick implementation of governmental countermeasures against COVID-19 and a general acceptance of these measures by the population. The behaviors of the population and the government, as well as the country's age distribution, may have contributed to the low incidence and small number of severe COVID-19 cases.

Favipiravir for the treatment of patients with COVID-19: a systematic review and meta-analysis.

BACKGROUND: Favipiravir possesses high utility for treating patients with COVID-19. However, research examining the efficacy and safety of favipiravir for patients with COVID-19 is limited. METHODS: We conducted a systematic review of published studies reporting the efficacy of favipiravir against COVID-19. Two investigators independently searched PubMed, the Cochrane Database of Systematic Reviews, MedRxiv, and ClinicalTrials.gov (inception to September 2020) to identify eligible studies. A meta-analysis was performed to measure viral clearance and clinical improvement as the primary outcomes. RESULTS: Among 11 eligible studies, 5 included a comparator group. Comparing to the comparator group, the favipiravir group exhibited significantly better viral clearance on day 7 after the initiation of treatment (odds ratio [OR] = 2.49, 95% confidence interval [CI] = 1.19-5.22), whereas no difference was noted on day 14 (OR = 2.19, 95% CI = 0.69-6.95). Although clinical improvement was significantly better in the favipiravir group on both days 7 and 14, the improvement was better on day 14 (OR = 3.03, 95% CI = 1.17-7.80) than on day 7 (OR = 1.60, 95% CI = 1.03-2.49). The estimated proportions of patients with viral clearance in the favipiravir arm on days 7 and 14 were 65.42 and 88.9%, respectively, versus 43.42 and 78.79%, respectively, in the comparator group. The estimated proportions of patients with clinical improvement on days 7 and 14 in the favipiravir group were 54.33 and 84.63%, respectively, compared with 34.40 and 65.77%, respectively, in the comparator group. CONCLUSIONS: Favipiravir induces viral clearance by 7 days and contributes to clinical improvement within 14 days. The results indicated that favipiravir has strong possibility for treating COVID-19, especially in patients with mild-to-moderate illness. Additional well-designed studies, including examinations of the dose and duration of treatment, are crucial for reaching definitive conclusions.

[Advanced Pharmaceutical Management Functions in Home Pharmaceutical Care].

Patients who receive home visits by pharmacists show a wide range of diseases.The patients are mainly elderly people with chronic diseases, children with some diseases or disabilities, and cancer patients receiving palliative care.Such patients request various pharmaceutical care at home from pharmacies.Pharmacies are essentially medical facilities and they must receive prescriptions from all patients, but depending on each pharmacy, there are few cases of a pharmacy refusing to receive prescriptions.Pharmacies participating in home pharmaceutical care need to establish a system incorporating 1 ) sufficient number of pharmacists, 2 ) pharmacy aseptic unit, 3 ) stockpiling of medical narcotics, and 4 ) stockpiling of medical supplies.However, because individual pharmacies have different situations, such as the intention of the founder, size of the facility, and experience and regionality of pharmacists, it is impossible for all pharmacies to participate in home pharmaceutical care in the same way.An increasing number of home patients with high dependence on medical care is expected in the future.For these patients, pharmacists need high clinical experiences, and at the same time, the burden on pharmacies to stockpile medicines will increase.Therefore, evaluation of pharmacies for home care patients with high dependence on medical care should be considered as an advanced pharmaceutical management function.

[Construction of a Home-Visiting System as a Family Pharmacy].

"The Vision for Patient-centered Pharmacies," published by the Ministry of Health, Labour and Welfare(MHLW)in October 2015 specifies three functions of family pharmacies, including home medical care. In 1994, home-visits by pharmacists officially began; however, before then, we had already visited patients whose medications and life situations were of concern, at their homes. Based on that experience, as we were planning to undertake home-visits after their institutionalization, we conducted a study of a system that would promote home care using pharmacists handling various duties, including prescriptions and health consulting. Considering the pharmacists' years of experience and work shifts, efficiency/productivity, and the role of a family pharmacy, we developed a home medical care support system by allocating two pharmacists to each patient's home. Thus, we concluded that if the entire pharmacy would be involved in home-visiting services along with outpatient prescription dispensing services as part of continuous follow-up of patients from hospital visits to home care, the pharmacy would eventually serve as a family pharmacy in the community.