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3.
Br J Hosp Med (Lond) ; 82(2): 1-4, 2021 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-33646036

RESUMEN

The UK government recently decided to extend the interval between the first dose of the Pfizer BioNTech and AstraZeneca COVID-19 vaccines from 3 weeks to 12 weeks to maximise the number of people receiving the initial dose, despite the trials only providing vaccine efficacy data based on a schedule of 21 days between doses. This editorial discusses whether there is evidence to support this policy change.


Asunto(s)
Inmunogenicidad Vacunal , Cobertura de Vacunación , Vacunación , /epidemiología , /prevención & control , /inmunología , Esquema de Medicación , Medicina Basada en la Evidencia/métodos , Medicina Basada en la Evidencia/normas , Regulación Gubernamental , Política de Salud/legislación & jurisprudencia , Humanos , Formulación de Políticas , Reino Unido/epidemiología , Vacunación/métodos , Vacunación/normas , Vacunación/estadística & datos numéricos , Cobertura de Vacunación/métodos , Cobertura de Vacunación/normas
5.
Milbank Q ; 99(1): 240-272, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33751664

RESUMEN

Policy Points  Spending on prescription drugs is much higher per capita in the United States than in most other industrialized nations, including France.  Lower prescription drug spending in France is due to different approaches to managing drug prices, volume of prescribing, and global health budgets.  Linking a drug's price to value both at the launch of the drug and over its lifetime is key to controlling spending. Regulations on prescription volume and global spending complement the interventions on prices.  If the United States adopted the French approach to regulating drug pricing, Medicare could potentially save billions of dollars annually on prescription drug spending. CONTEXT: Prescription drug spending per capita in the United States is higher than in most other industrialized countries. Policymakers seeking to lower drug spending often suggest benchmarking prices against other countries, including France, which spends half as much as the United States per capita on prescription drugs. Because differences in drug prices may result from how markets are organized in each nation, we sought to directly compare drug prices and pricing regulations between the United States and France. METHODS: For the six brand-name drugs with the highest gross expenditures in Medicare Part D in 2017, we compared the price dynamics in France and the United States between 2010 and 2018 and analyzed associations between price changes in each country and key regulatory events. We also comprehensively reviewed US and French laws and regulations related to drug pricing. FINDINGS: Prices for the six drugs studied were higher in the United States than in France. In 2018, if Medicare had paid French prices for the brand-name drugs in our cohort, the agency would have saved $5.1 billion. We identified 12 factors that explain why the United States spends more than France on drugs, including variations in unit prices and the volume of prescriptions, driven by use of health technology assessment and value-based pricing in France. CONCLUSIONS: Key drivers of lower drug spending in France compared to the United States are that the French government regulates drug prices when products are launched and prohibits substantial price increases after launch. The regulation of prescription drugs in France is governed by rules that can inform discussions of US prescription drug policy and potential Medicare price negotiations.


Asunto(s)
Ahorro de Costo , Regulación Gubernamental , Medicare Part D/economía , Medicamentos bajo Prescripción/economía , Costos y Análisis de Costo , Costos de los Medicamentos/legislación & jurisprudencia , Francia , Cobertura del Seguro , Legislación de Medicamentos , Estados Unidos
6.
Respirology ; 26(4): 322-333, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33690946

RESUMEN

COVID-19 has hit the world by surprise, causing substantial mortality and morbidity since 2020. This narrative review aims to provide an overview of the epidemiology, induced impact, viral kinetics and clinical spectrum of COVID-19 in the Asia-Pacific Region, focusing on regions previously exposed to outbreaks of coronavirus. COVID-19 progressed differently by regions, with some (such as China and Taiwan) featured by one to two epidemic waves and some (such as Hong Kong and South Korea) featured by multiple waves. There has been no consensus on the estimates of important epidemiological time intervals or proportions, such that using them for making inferences should be done with caution. Viral loads of patients with COVID-19 peak in the first week of illness around days 2 to 4 and hence there is very high transmission potential causing community outbreaks. Various strategies such as government-guided and suppress-and-lift strategies, trigger-based/suppression approaches and alert systems have been employed to guide the adoption and easing of control measures. Asymptomatic and pre-symptomatic transmission is a hallmark of COVID-19. Identification and isolation of symptomatic patients alone is not effective in controlling the ongoing outbreaks. However, early, prompt and coordinated enactment predisposed regions to successful disease containment. Mass COVID-19 vaccinations are likely to be the light at the end of the tunnel. There is a need to review what we have learnt in this pandemic and examine how to transfer and improve existing knowledge for ongoing and future epidemics.


Asunto(s)
Control de Enfermedades Transmisibles , Asia/epidemiología , Australasia/epidemiología , /fisiopatología , /virología , Defensa Civil/organización & administración , Control de Enfermedades Transmisibles/legislación & jurisprudencia , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Control de Enfermedades Transmisibles/estadística & datos numéricos , Regulación Gubernamental , Humanos , Cooperación Internacional , /fisiología
8.
Evol Psychol ; 19(1): 14747049211000714, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33752457

RESUMEN

It is puzzling why countries do not all implement stringent behavioral control measures to prevent the spread of COVID-19 even though preventive behaviors have been proven to be the only effective means to stop the pandemic. We provide a novel evolutionary life history explanation whereby pathogenic and parasitic prevalence represents intrinsic rather than extrinsic mortality risk that drives slower life history strategies and the related disease control motivation in all animals but especially humans. Our theory was tested and supported based on publicly available data involving over 150 countries. Countries having a higher historical prevalence of infectious diseases are found to adopt slower life history strategies that are related to prompter COVID-19 containment actions by the government and greater compliance by the population. Findings could afford governments novel insight into the design of more effective COVID-19 strategies that are based on enhancing a sense of control, vigilance, and compliance in the general population.


Asunto(s)
Control de la Conducta , Control de Enfermedades Transmisibles , Infecciones , Rasgos de la Historia de Vida , Conducta de Reducción del Riesgo , Control de la Conducta/legislación & jurisprudencia , Control de la Conducta/métodos , Control de la Conducta/psicología , /prevención & control , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/tendencias , Conducta Cooperativa , Salud Global , Regulación Gubernamental , Humanos , Infecciones/epidemiología , Infecciones/psicología , Infecciones/transmisión , Prevalencia
9.
Ann Glob Health ; 87(1): 23, 2021 02 25.
Artículo en Inglés | MEDLINE | ID: mdl-33665145

RESUMEN

Introduction: Rwanda has made significant advancements in medical and economic development over the last 20 years and has emerged as a leader in healthcare in the East African region. The COVID-19 pandemic, which reached Rwanda in March 2020, presented new and unique challenges for infectious disease control. The objective of this paper is to characterize Rwanda's domestic response to the first year of the COVID-19 pandemic and highlight effective strategies so that other countries, including high and middle-income countries, can learn from its innovative initiatives. Methods: Government publications describing Rwanda's healthcare capacity were first consulted to obtain the country's baseline context. Next, official government and healthcare system communications, including case counts, prevention and screening protocols, treatment facility practices, and behavioral guidelines for the public, were read thoroughly to understand the course of the pandemic in Rwanda and the specific measures in the response. Results: As of 31 December 2020, Rwanda has recorded 8,383 cumulative COVID-19 cases, 6,542 recoveries, and 92 deaths since the first case on 14 March 2020. The Ministry of Health, Rwanda Biomedical Centre, and the Epidemic and Surveillance Response division have collaborated on preparative measures since the pandemic began in January 2020. The formation of a Joint Task Force in early March led to the Coronavirus National Preparedness and Response Plan, an extensive six-month plan that established a national incident management system and detailed four phases of a comprehensive national response. Notable strategies have included disseminating public information through drones, robots for screening and inpatient care, and official communications through social media platforms to combat misinformation and mobilize a cohesive response from the population. Conclusion: Rwanda's government and healthcare system has responded to the COVID-19 pandemic with innovative interventions to prevent and contain the virus. Importantly, the response has utilized adaptive and innovative technology and robust risk communication and community engagement to deliver an effective response to the COVID-19 pandemic.


Asunto(s)
Control de Enfermedades Transmisibles , Prestación de Atención de Salud , Regulación Gubernamental , Gestión de Riesgos , /epidemiología , Gestión del Cambio , Control de Enfermedades Transmisibles/legislación & jurisprudencia , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Comunicación , Prestación de Atención de Salud/organización & administración , Prestación de Atención de Salud/tendencias , Transmisión de Enfermedad Infecciosa/prevención & control , Humanos , Innovación Organizacional , Gestión de Riesgos/métodos , Gestión de Riesgos/organización & administración , Rwanda/epidemiología
11.
Front Public Health ; 9: 597808, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33681124

RESUMEN

COVID-19, caused by SARS-CoV-2, was first reported in Wuhan, China and is now a pandemic affecting over 218 countries and territories around the world. Nepal has been severely affected by it, with an increasing number of confirmed cases and casualties in recent days, even after 8 months of the first case detected in China. As of 26 November 2020, there were over 227,600 confirmed cases of COVID in Nepal with 209,435 recovered cases and 1,412 deaths. This study aimed to compile public data available from the Ministry of Health and Population (MoHP), Government of Nepal (GoN) and analyse the data of 104 deceased COVID-19 patients using IBM SPSS (Version 25.0). Additionally, this study also aimed to provide critical insights on response of the GoN to COVID-19 and way forward to confront unprecedented pandemic. Figures and maps were created using the Origin Lab (Version 2018) and QGIS (Version 3.10.8). Most of the reported cases were from Bagmati Province, the location of Nepal's capital city, Kathmandu. Among deceased cases, >69% of the patients were male and patients ≥54 years accounted for 67.9% (n = 923). Preliminary findings showed respiratory illness, diabetes, and chronic kidney diseases were the most common comorbid conditions associated with COVID-19 deaths in Nepal. Despite some efforts in the 8 months since the first case was detected, the government's response so far has been insufficient. Since the government eased the lockdown in July 2020, Nepal is facing a flood of COVID-19 cases. If no aggressive actions are taken, the epidemic is likely to result in significant morbidity and mortality in Nepal. The best way to curb the effect of the ongoing pandemic in a resource-limited country like Nepal is to increase testing, tracing, and isolation capacity, and to set up quality quarantine centers throughout the nation. A comprehensive health literacy campaign, quality care of older adults and those with comorbidity will also result in the effective management of the ongoing pandemic.


Asunto(s)
/prevención & control , Control de Enfermedades Transmisibles/organización & administración , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , /mortalidad , Niño , Preescolar , Control de Enfermedades Transmisibles/métodos , Trazado de Contacto , Países en Desarrollo , Femenino , Regulación Gubernamental , Humanos , Programas de Inmunización , Lactante , Masculino , Persona de Mediana Edad , Nepal/epidemiología , Cuarentena , Adulto Joven
15.
J Stud Alcohol Drugs ; 82(1): 42-54, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33573721

RESUMEN

OBJECTIVE: Licensed premises face particular challenges to operating safely within COVID-19 restrictions. Following a U.K. national lockdown from March 20, 2020, we studied business practices and behaviors in licensed premises to inform COVID-19 policies. To our knowledge, no previous study worldwide has examined these issues. METHOD: Before premises reopened in Scotland, we conducted in-depth telephone interviews (May-June 2020) with participants from hospitality trade associations, licensed premises, or in related roles (n = 18). Interviews focused on anticipated business practices and challenges relevant to minimizing COVID-19 transmission. Following reopening (July-August 2020), we conducted observations of relevant practices and behaviors in 29 bars purposively sampled for diversity, using a structured schedule. Interviews and observation reports were analyzed thematically. RESULTS: Interviewees generally sought clarity, flexibility, and balance in government guidance on reopening, and they cited commercial and practical challenges to doing so safely. Alcohol consumption was perceived as an additional but potentially manageable challenge. Most observed premises had made physical and operational modifications; however, practices were variable. Observed incidents of concern included close physical interaction between customers and with staff, frequently featuring alcohol intoxication and rarely effectively stopped by staff. CONCLUSIONS: Despite the efforts of bar operators and guidance from government, potentially significant risks of COVID-19 transmission persisted in a substantial minority of observed bars, especially when customers were intoxicated.


Asunto(s)
Consumo de Bebidas Alcohólicas/efectos adversos , Intoxicación Alcohólica/prevención & control , /transmisión , Comercio , Adulto , Intoxicación Alcohólica/complicaciones , Femenino , Regulación Gubernamental , Humanos , Masculino , Factores de Riesgo
17.
Artículo en Ruso | MEDLINE | ID: mdl-33591668

RESUMEN

The term "regulatory guillotine" means analysis of all existing normative legal acts in order to understand their compliance with modern requirements. If these regulations meet the requirements, then the rules remain; if not, they must either be canceled and new regulation to be elaborated or corresponding changes must be implemented to current regulation. To resolve this problem, the government of the Russian Federation decided to implement the "regulatory guillotine" procedure. The main task of this procedure is to completely replace the entire array of norms that establish mandatory requirements with new ones by January 1, 2021. This will reduce administrative burden on business and increase level of security for consumers of various services. The same work is applied to the standards regulating management of quality and safety of medical activities. The article analyzes normative legal acts that regulate quality and safety management of medical activities, as well as new normative legal acts that are already accepted but still are not entered into force.


Asunto(s)
Comercio , Regulación Gubernamental , Medicina , Federación de Rusia
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