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2.
Artículo en Inglés | MEDLINE | ID: mdl-33020395

RESUMEN

In the wake of the sudden spread of COVID-19, a large amount of the Italian population practiced incongruous behaviors with the protective health measures. The present study aimed at examining psychological and psychosocial variables that could predict behavioral compliance. An online survey was administered from 18-22 March 2020 to 2766 participants. Paired sample t-tests were run to compare efficacy perception with behavioral compliance. Mediation and moderated mediation models were constructed to explore the association between perceived efficacy and compliance, mediated by self-efficacy and moderated by risk perception and civic attitudes. Machine learning algorithms were trained to predict which individuals would be more likely to comply with protective measures. Results indicated significantly lower scores in behavioral compliance than efficacy perception. Risk perception and civic attitudes as moderators rendered the mediating effect of self-efficacy insignificant. Perceived efficacy on the adoption of recommended behaviors varied in accordance with risk perception and civic engagement. The 14 collected variables, entered as predictors in machine learning models, produced an ROC area in the range of 0.82-0.91 classifying individuals as high versus low compliance. Overall, these findings could be helpful in guiding age-tailored information/advertising campaigns in countries affected by COVID-19 and directing further research on behavioral compliance.


Asunto(s)
Control de Enfermedades Transmisibles/métodos , Infecciones por Coronavirus/prevención & control , Aprendizaje Automático , Pandemias/prevención & control , Cooperación del Paciente/estadística & datos numéricos , Neumonía Viral/prevención & control , Algoritmos , Betacoronavirus , Humanos , Italia
3.
Artículo en Inglés | MEDLINE | ID: mdl-33007985

RESUMEN

The COVID-19 pandemic represents a massive global health crisis. The rapid transmission rate of the virus, as well as the lack of effective medications and vaccines, has posed serious challenges to controlling the spread of the disease. Dealing with this public health crisis has required major changes in people's behavior, including the adoption of social distancing measures such as avoiding meeting with family members and friends, crowded places, and public transportation. The purpose of this study is to investigate the factors associated with the adoption of these behaviors in China and Israel. We relied on the 3Cs model that has been used to predict the adoption of a specific preventive behavior (vaccinations) with the goal of testing its applicability to other preventive behaviors such as in response to the COVID-19 pandemic. The model indicates that confidence in social institutions, complacency (fear of and assessments about the risk of becoming ill) and constraints (levels of self-efficacy and confidence in being able to engage in the behaviors) are predictors of adopting preventive behaviors. Data were collected in China and Israel through an online survey of the population (n = 1406). We used latent variables and structural equation modeling to test the hypotheses derived from the 3Cs model. The findings indicate that there are some differences in the types of preventive behaviors adopted in the two countries. In Israel, higher levels of confidence predicted the adoption of avoidant behaviors and more constraints predicted engaging in fewer avoidant behaviors. In China, more constraints also contributed to the adoption of fewer avoidant behaviors, but people's level of confidence fully mediated this result. The multi-group analysis indicated that the conceptualized model fits the Chinese and Israeli data reasonably well. The findings suggest that the 3Cs model can be generalized from getting vaccinated to adopting avoidant behaviors and that the model can be used across cultures and countries.


Asunto(s)
Control de Enfermedades Transmisibles/métodos , Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Vacunación/psicología , Betacoronavirus , China , Humanos , Israel , Conducta Social , Aislamiento Social
5.
BMJ Open ; 10(10): e038390, 2020 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-33004397

RESUMEN

INTRODUCTION: In order to avoid unnecessary hospital admission and associated complications, there is an urgent need to improve the early detection of infection in nursing home residents. Monitoring signs and symptoms with checklists or aids called decision support tools may help nursing home staff to detect infection in residents, particularly during the current COVID-19 pandemic.We plan to conduct a survey exploring views and experiences of how infections are detected and managed in practice by nurses, care workers and managers in nursing homes in England and Sweden. METHODS AND ANALYSIS: An international cross-sectional descriptive survey, using a pretested questionnaire, will be used to explore nurses, care workers and managers views and experiences of how infections are detected and managed in practice in nursing homes. Data will be analysed descriptively and univariate associations between personal and organisational factors explored. This will help identify important factors related to awareness, knowledge, attitudes, belief and skills likely to affect future implementation of a decision support tool for the early detection of infection in nursing home residents. ETHICS AND DISSEMINATION: This study was approved using the self-certification process at the University of Surrey and Linköping University ethics committee (Approval 2018/514-32) in 2018. Study findings will be disseminated through community/stakeholder/service user engagement events in each country, publication in academic peer-reviewed journals and conference presentations. A LAY summary will be provided to participants who indicate they would like to receive this information.This is the first stage of a plan of work to revise and evaluate the Early Detection of Infection Scale (EDIS) tool and its effect on managing infections and reducing unplanned hospital admissions in nursing home residents. Implementation of the EDIS tool may have important implications for the healthcare economy; this will be explored in cost-benefit analyses as the work progresses.


Asunto(s)
Control de Enfermedades Transmisibles , Infecciones por Coronavirus , Uso Excesivo de los Servicios de Salud/prevención & control , Casas de Salud/estadística & datos numéricos , Pandemias , Manejo de Atención al Paciente , Neumonía Viral , Instituciones de Cuidados Especializados de Enfermería/estadística & datos numéricos , Betacoronavirus/aislamiento & purificación , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/terapia , Análisis Costo-Beneficio , Estudios Transversales , Inglaterra/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud/normas , Hospitalización , Humanos , Manejo de Atención al Paciente/economía , Manejo de Atención al Paciente/métodos , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/terapia , Gestión de la Práctica Profesional/economía , Proyectos de Investigación , Suecia/epidemiología
7.
BMC Med ; 18(1): 316, 2020 10 05.
Artículo en Inglés | MEDLINE | ID: mdl-33012285

RESUMEN

BACKGROUND: Many low- and middle-income countries have implemented control measures against coronavirus disease 2019 (COVID-19). However, it is not clear to what extent these measures explain the low numbers of recorded COVID-19 cases and deaths in Africa. One of the main aims of control measures is to reduce respiratory pathogen transmission through direct contact with others. In this study, we collect contact data from residents of informal settlements around Nairobi, Kenya, to assess if control measures have changed contact patterns, and estimate the impact of changes on the basic reproduction number (R0). METHODS: We conducted a social contact survey with 213 residents of five informal settlements around Nairobi in early May 2020, 4 weeks after the Kenyan government introduced enhanced physical distancing measures and a curfew between 7 pm and 5 am. Respondents were asked to report all direct physical and non-physical contacts made the previous day, alongside a questionnaire asking about the social and economic impact of COVID-19 and control measures. We examined contact patterns by demographic factors, including socioeconomic status. We described the impact of COVID-19 and control measures on income and food security. We compared contact patterns during control measures to patterns from non-pandemic periods to estimate the change in R0. RESULTS: We estimate that control measures reduced physical contacts by 62% and non-physical contacts by either 63% or 67%, depending on the pre-COVID-19 comparison matrix used. Masks were worn by at least one person in 92% of contacts. Respondents in the poorest socioeconomic quintile reported 1.5 times more contacts than those in the richest. Eighty-six percent of respondents reported a total or partial loss of income due to COVID-19, and 74% reported eating less or skipping meals due to having too little money for food. CONCLUSION: COVID-19 control measures have had a large impact on direct contacts and therefore transmission, but have also caused considerable economic and food insecurity. Reductions in R0 are consistent with the comparatively low epidemic growth in Kenya and other sub-Saharan African countries that implemented similar, early control measures. However, negative and inequitable impacts on economic and food security may mean control measures are not sustainable in the longer term.


Asunto(s)
Control de Enfermedades Transmisibles , Infecciones por Coronavirus , Transmisión de Enfermedad Infecciosa/prevención & control , Relaciones Interpersonales , Pandemias , Neumonía Viral , Adulto , Betacoronavirus , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Control de Enfermedades Transmisibles/estadística & datos numéricos , Infecciones por Coronavirus/economía , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Femenino , Humanos , Kenia/epidemiología , Masculino , Evaluación de Resultado en la Atención de Salud , Pandemias/economía , Pandemias/prevención & control , Neumonía Viral/economía , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Pobreza/estadística & datos numéricos , Aislamiento Social , Factores Socioeconómicos , Encuestas y Cuestionarios
10.
PLoS One ; 15(9): e0238559, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32886696

RESUMEN

The novel coronavirus (SARS-CoV-2), identified in China at the end of December 2019 and causing the disease COVID-19, has meanwhile led to outbreaks all over the globe with about 2.2 million confirmed cases and more than 150,000 deaths as of April 17, 2020. In this work, mathematical models are used to reproduce data of the early evolution of the COVID-19 outbreak in Germany, taking into account the effect of actual and hypothetical non-pharmaceutical interventions. Systems of differential equations of SEIR type are extended to account for undetected infections, stages of infection, and age groups. The models are calibrated on data until April 5. Data from April 6 to 14 are used for model validation. We simulate different possible strategies for the mitigation of the current outbreak, slowing down the spread of the virus and thus reducing the peak in daily diagnosed cases, the demand for hospitalization or intensive care units admissions, and eventually the number of fatalities. Our results suggest that a partial (and gradual) lifting of introduced control measures could soon be possible if accompanied by further increased testing activity, strict isolation of detected cases, and reduced contact to risk groups.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Modelos Teóricos , Neumonía Viral/epidemiología , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/estadística & datos numéricos , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Transmisión de Enfermedad Infecciosa/estadística & datos numéricos , Alemania/epidemiología , Hospitalización/estadística & datos numéricos , Humanos , Lactante , Persona de Mediana Edad , Pandemias/prevención & control , Neumonía Viral/prevención & control , Neumonía Viral/transmisión
11.
J Korean Med Sci ; 35(35): e321, 2020 Sep 07.
Artículo en Inglés | MEDLINE | ID: mdl-32893522

RESUMEN

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has posed significant global public health challenges and created a substantial economic burden. Korea has experienced an extensive outbreak, which was linked to a religion-related super-spreading event. However, the implementation of various non-pharmaceutical interventions (NPIs), including social distancing, spring semester postponing, and extensive testing and contact tracing controlled the epidemic. Herein, we estimated the effectiveness of each NPI using a simulation model. METHODS: A compartment model with a susceptible-exposed-infectious-quarantined-hospitalized structure was employed. Using the Monte-Carlo-Markov-Chain algorithm with Gibbs' sampling method, we estimated the time-varying effective contact rate to calibrate the model with the reported daily new confirmed cases from February 12th to March 31st (7 weeks). Moreover, we conducted scenario analyses by adjusting the parameters to estimate the effectiveness of NPI. RESULTS: Relaxed social distancing among adults would have increased the number of cases 27.4-fold until the end of March. Spring semester non-postponement would have increased the number of cases 1.7-fold among individuals aged 0-19, while lower quarantine and detection rates would have increased the number of cases 1.4-fold. CONCLUSION: Among the three NPI measures, social distancing in adults showed the highest effectiveness. The substantial effect of social distancing should be considered when preparing for the 2nd wave of COVID-19.


Asunto(s)
Control de Enfermedades Transmisibles/métodos , Trazado de Contacto/métodos , Infecciones por Coronavirus/transmisión , Tamizaje Masivo/métodos , Neumonía Viral/transmisión , Distancia Social , Betacoronavirus , Simulación por Computador , Exposición a Riesgos Ambientales/prevención & control , Humanos , Cadenas de Markov , Modelos Teóricos , Método de Montecarlo , Pandemias , Práctica de Salud Pública/legislación & jurisprudencia , República de Corea
12.
Prev Chronic Dis ; 17: E109, 2020 09 17.
Artículo en Inglés | MEDLINE | ID: mdl-32945766

RESUMEN

INTRODUCTION: In response to the coronavirus disease 2019 (COVID-19) pandemic, New York City closed all nonessential businesses and restricted the out-of-home activities of residents as of March 22, 2020. This order affected different neighborhoods differently, as stores and workplaces are not randomly distributed across the city, and different populations may have responded differently to the out-of-home restrictions. This study examines how the business closures and activity restrictions affected COVID-19 testing results. An evaluation of whether such actions slowed the spread of the pandemic is a crucial step in designing effective public health policies. METHODS: Daily data on the fraction of COVID-19 tests yielding a positive result at the zip code level were analyzed in relation to the number of visits to local businesses (based on smartphone location) and the number of smartphones that stayed fixed at their home location. The regression model also included vectors of fixed effects for the day of the week, the calendar date, and the zip code of residence. RESULTS: A large number of visits to local businesses increased the positivity rate of COVID-19 tests, while a large number of smartphones that stayed at home decreased it. A doubling in the relative number of visits increases the positivity rate by about 12.4 percentage points (95% CI, 5.3 to 19.6). A doubling in the relative number of stay-at-home devices lowered it by 2.0 percentage points (95% CI, -2.9 to -1.2). The business closures and out-of-home activity restrictions decreased the positivity rate, accounting for approximately 25% of the decline observed in April and May 2020. CONCLUSION: Policy measures decreased the likelihood of positive results in COVID-19 tests. These specific policy tools may be successfully used when comparable health crises arise in the future.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Técnicas de Laboratorio Clínico , Comercio/legislación & jurisprudencia , Control de Enfermedades Transmisibles , Infecciones por Coronavirus , Transmisión de Enfermedad Infecciosa , Pandemias , Neumonía Viral , Técnicas de Laboratorio Clínico/métodos , Técnicas de Laboratorio Clínico/estadística & datos numéricos , Control de Enfermedades Transmisibles/instrumentación , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/estadística & datos numéricos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Transmisión de Enfermedad Infecciosa/prevención & control , Transmisión de Enfermedad Infecciosa/estadística & datos numéricos , Humanos , Ciudad de Nueva York/epidemiología , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Formulación de Políticas , Gestión de la Salud Poblacional , Salud Pública/métodos , Salud Pública/estadística & datos numéricos , Medición de Riesgo/métodos , Teléfono Inteligente/estadística & datos numéricos , Distancia Social
13.
Rev Soc Bras Med Trop ; 53: e20200469, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32965454

RESUMEN

INTRODUCTION: Monitoring coronavirus disease (COVID-19)-related infections and deaths in Brazil is controversial, with increasing pressure to ease social distance measures. However, no evidence of a sustained, widespread fall in cases exists. METHODS: We used segmented (joinpoint) regression analysis to describe the behavior of COVID-19 infections in Brazilian capital cities. RESULTS: All capitals showed an exponential or a near-exponential increase in cases through May. A decline in reported cases was subsequently noted in 20 cities but was only significant for 8 (29.6%) and was followed in two by a renewed increase. CONCLUSIONS: Caution is warranted when considering the relaxation of restrictions.


Asunto(s)
Control de Enfermedades Transmisibles/métodos , Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Aislamiento Social , Betacoronavirus , Brasil , Humanos
14.
Tex Med ; 116(8): 20-25, 2020 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-32866271

RESUMEN

Ricardo Garza, MD, was still walking the tightrope: standing, but unable to withstand another gust of wind. COVID-19 swept away about 35% of the San Antonio solo cardiologist's practice revenue, and that was just what he could calculate as he waited for insurers to process straggling claims. But he had returned to in-office operations without any layoffs. While some practices are surviving - and trying their best to prepare for future threats - others weren't so lucky. On-the-ground experiences align with the Texas Medical Association's Practice Viability Survey in showing COVID-19 was, and still is, a disruptor unlike any other - challenging or torpedoing the viability of various practice types.


Asunto(s)
Control de Enfermedades Transmisibles/métodos , Infecciones por Coronavirus , Pandemias , Neumonía Viral , Práctica Profesional , Telemedicina , Betacoronavirus , Infecciones por Coronavirus/economía , Infecciones por Coronavirus/epidemiología , Toma de Decisiones en la Organización , Transmisión de Enfermedad Infecciosa/prevención & control , Humanos , Innovación Organizacional , Pandemias/economía , Neumonía Viral/economía , Neumonía Viral/epidemiología , Pautas de la Práctica en Medicina/organización & administración , Pautas de la Práctica en Medicina/tendencias , Práctica Profesional/economía , Práctica Profesional/tendencias , Texas/epidemiología
16.
F1000Res ; 9: 352, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32864104

RESUMEN

Background: School closures have been a recommended non-pharmaceutical intervention in pandemic response owing to the potential to reduce transmission of infection between children, school staff and those that they contact. However, given the many roles that schools play in society, closure for any extended period is likely to have additional impacts. Literature reviews of research exploring school closure to date have focused upon epidemiological effects; there is an unmet need for research that considers the multiplicity of potential impacts of school closures. Methods: We used systematic searching, coding and synthesis techniques to develop a systems-based logic model. We included literature related to school closure planned in response to epidemics large and small, spanning the 1918-19 'flu pandemic through to the emerging literature on the 2019 novel coronavirus. We used over 170 research studies and a number of policy documents to inform our model. Results: The model organises the concepts used by authors into seven higher level domains: children's health and wellbeing, children's education, impacts on teachers and other school staff, the school organisation, considerations for parents and families, public health considerations, and broader economic impacts. The model also collates ideas about potential moderating factors and ethical considerations. While dependent upon the nature of epidemics experienced to date, we aim for the model to provide a starting point for theorising about school closures in general, and as part of a wider system that is influenced by contextual and population factors. Conclusions: The model highlights that the impacts of school closures are much broader than those related solely to health, and demonstrates that there is a need for further concerted work in this area. The publication of this logic model should help to frame future research in this area and aid decision-makers when considering future school closure policy and possible mitigation strategies.


Asunto(s)
Control de Enfermedades Transmisibles/métodos , Infecciones por Coronavirus/prevención & control , Gripe Humana/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Instituciones Académicas , Betacoronavirus , Brotes de Enfermedades/prevención & control , Humanos , Modelos Teóricos
17.
R I Med J (2013) ; 103(7): 15-20, 2020 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-32872685

RESUMEN

In December 2019 a respiratory illness known as Coronavirus 2 (SARS-CoV-2, COVID-19) broke out in a region in China and rapidly spread to become a pandemic affecting all sporting events worldwide. The Summer Olympics scheduled to be held in Tokyo were postponed until 2021, and all professional leagues in the United States postponed or canceled events. As the United States has begun to open up, there remains uncertainty of when sporting events can safely be held. Many professional leagues and the National Collegiate Athletic Association have established guidelines and recommendations for their athletes to compete safely. In this article, we review the protocols that have been established to allow athletes to return to play, and we review briefly the effects COVID-19 infection may have on athletes.


Asunto(s)
Control de Enfermedades Transmisibles , Infecciones por Coronavirus , Transmisión de Enfermedad Infecciosa/prevención & control , Pandemias , Neumonía Viral , Volver al Deporte , Deportes/tendencias , Atletas , Betacoronavirus , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Humanos , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Medición de Riesgo
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