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1.
J Racial Ethn Health Disparities ; 10(4): 1597-1604, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-35689156

RESUMO

Black Americans are more likely to be essential workers due to racial capitalism. Because of the COVID-19 pandemic, essential workers are less able to adhere to social distancing and stay-at-home guidelines due to the nature of their work, because they are more likely to occupy crowded households, and are more likely to possess pre-existing health conditions. To assist Black essential workers in preventing infection or reducing the intensity of symptoms if contracted, vaccination against the virus is essential. Unfortunately, Black essential workers face considerable barriers to accessing vaccinations and are hesitant to receive the vaccine due to widespread misinformation and justified historical mistrust of the American medical system. The purpose of this work is to (1) describe the disproportionate impact of COVID-19 on Black essential workers due to racial capitalism, (2) outline the socioeconomic and racial barriers related to vaccination within this population, and (3) to suggest policy-related approaches to facilitate vaccination such as access to on-site vaccination opportunities, the funding of community outreach efforts, and the mandating of increased employee benefits.


Assuntos
População Negra , COVID-19 , Capitalismo , Controle de Doenças Transmissíveis , Equidade em Saúde , Racismo Sistêmico , Humanos , COVID-19/economia , COVID-19/epidemiologia , COVID-19/etnologia , COVID-19/prevenção & controle , Pandemias/economia , Políticas , Política de Saúde/economia , Vacinas contra COVID-19/economia , Vacinas contra COVID-19/provisão & distribuição , Acessibilidade aos Serviços de Saúde/economia , Equidade em Saúde/economia , Racismo Sistêmico/economia , Racismo Sistêmico/etnologia , Controle de Doenças Transmissíveis/economia , Controle de Doenças Transmissíveis/métodos
3.
PLoS One ; 17(1): e0261759, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35061722

RESUMO

In the beginning of the COVID-19 US epidemic in March 2020, sweeping lockdowns and other aggressive measures were put in place and retained in many states until end of August of 2020; the ensuing economic downturn has led many to question the wisdom of the early COVID-19 policy measures in the US. This study's objective was to evaluate the cost and benefit of the US COVID-19-mitigating policy intervention during the first six month of the pandemic in terms of COVID-19 mortality potentially averted, versus mortality potentially attributable to the economic downturn. We conducted a synthesis-based retrospective cost-benefit analysis of the full complex of US federal, state, and local COVID-19-mitigating measures, including lockdowns and all other COVID-19-mitigating measures, against the counterfactual scenario involving no public health intervention. We derived parameter estimates from a rapid review and synthesis of recent epidemiologic studies and economic literature on regulation-attributable mortality. According to our estimates, the policy intervention saved 866,350-1,711,150 lives (4,886,214-9,650,886 quality-adjusted life-years), while mortality attributable to the economic downturn was 57,922-245,055 lives (2,093,811-8,858,444 life-years). We conclude that the number of lives saved by the spring-summer lockdowns and other COVID-19-mitigation was greater than the number of lives potentially lost due to the economic downturn. However, the net impact on quality-adjusted life expectancy is ambiguous.


Assuntos
COVID-19/epidemiologia , Análise Custo-Benefício/estatística & dados numéricos , Modelos Estatísticos , Saúde Pública/economia , Anos de Vida Ajustados por Qualidade de Vida , Quarentena/economia , COVID-19/economia , Controle de Doenças Transmissíveis/economia , Controle de Doenças Transmissíveis/métodos , Humanos , Saúde Pública/estatística & dados numéricos , Qualidade de Vida/psicologia , Quarentena/ética , Estudos Retrospectivos , SARS-CoV-2/patogenicidade , Estados Unidos/epidemiologia
4.
PLoS Negl Trop Dis ; 15(12): e0009904, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34928945

RESUMO

Since its early spread in early 2020, the disease caused by the novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Coronavirus Disease 2019 (COVID-19) has caused mass disruptions to health services. These have included interruptions to programs that aimed to prevent, control, and eliminate neglected tropical diseases (NTDs). In March 2020, the World Health Organization (WHO) released interim guidelines recommending the temporary cessation of mass drug administration (MDA), community-based surveys, and case detection, while encouraging continuation of morbidity management and vector control where possible. Over the course of the following months, national programs and implementing partners contributed to COVID-19 response efforts, while also beginning to plan for resumption of NTD control activities. To understand the challenges, opportunities, and recommendations for maximizing continuity of disease control during public health emergencies, we sought perspectives from Nigeria and Guinea on the process of restarting NTD control efforts during the COVID-19 pandemic. Through semistructured interviews with individuals involved with NTD control at the local and national levels, we identified key themes and common perspectives between the 2 countries, as well as observations that were specific to each. Overall, interviewees stressed the challenges posed by COVID-19 interruptions, particularly with respect to delays to activities and related knock-on impacts, such as drug expiry and prolonged elimination timelines, as well as concerns related to funding. However, respondents in both countries also highlighted the benefits of a formal risk assessment approach, particularly in terms of encouraging information sharing and increasing coordination and advocacy. Recommendations included ensuring greater availability of historical data to allow better monitoring of how future emergencies affect NTD control progress; continuing to use risk assessment approaches in the future; and identifying mechanisms for sharing lessons learned and innovations between countries as a means of advancing postpandemic health systems and disease control capacity strengthening.


Assuntos
COVID-19 , Controle de Doenças Transmissíveis/organização & administração , Doenças Negligenciadas/prevenção & controle , Controle de Doenças Transmissíveis/economia , Programas Governamentais/economia , Programas Governamentais/organização & administração , Guiné , Humanos , Administração Massiva de Medicamentos , Nigéria , SARS-CoV-2 , Medicina Tropical/métodos
6.
Sci Rep ; 11(1): 22855, 2021 11 24.
Artigo em Inglês | MEDLINE | ID: mdl-34819577

RESUMO

Policymakers commonly employ non-pharmaceutical interventions to reduce the scale and severity of pandemics. Of non-pharmaceutical interventions, physical distancing policies-designed to reduce person-to-person pathogenic spread - have risen to recent prominence. In particular, stay-at-home policies of the sort widely implemented around the globe in response to the COVID-19 pandemic have proven to be markedly effective at slowing pandemic growth. However, such blunt policy instruments, while effective, produce numerous unintended consequences, including potentially dramatic reductions in economic productivity. In this study, we develop methods to investigate the potential to simultaneously contain pandemic spread while also minimizing economic disruptions. We do so by incorporating both occupational and contact network information contained within an urban environment, information that is commonly excluded from typical pandemic control policy design. The results of our methods suggest that large gains in both economic productivity and pandemic control might be had by the incorporation and consideration of simple-to-measure characteristics of the occupational contact network. We find evidence that more sophisticated, and more privacy invasive, measures of this network do not drastically increase performance.


Assuntos
COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/economia , Controle de Doenças Transmissíveis/métodos , Busca de Comunicante/economia , Busca de Comunicante/métodos , Transmissão de Doença Infecciosa/prevenção & controle , Humanos , Ocupações/classificação , Pandemias , Distanciamento Físico , Políticas , Análise de Componente Principal , Quarentena/economia , Quarentena/métodos , Quarentena/tendências , SARS-CoV-2/patogenicidade
7.
J Prim Health Care ; 13(2): 116-120, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34620292

RESUMO

During the first months of the coronavirus disease 2019 (COVID-19) pandemic in early 2020, South Korea stood as one of the most successful in preventing a nationwide outbreak. The country was unique in that it did so without enforcing massive border restrictions and tight social distancing measures, instead focusing on maximal testing, contact tracing, and treatment. But as the year 2020 went on, the country has suffered second and third waves, each one being larger and harder to combat than the last. The Korean government, however, has been unwilling to impose stringent measures due to potential economic consequences and has still relied on its initial strategies in an attempt to prevent further disease transmission. It is therefore crucial to revisit their position beyond their early successes to re-evaluate the effectiveness of their strategy, and to finally decide if it is time to move on to more drastic measures.


Assuntos
COVID-19/prevenção & controle , Controle de Doenças Transmissíveis , Pandemias/prevenção & controle , Teste para COVID-19 , Controle de Doenças Transmissíveis/economia , Controle de Doenças Transmissíveis/métodos , Busca de Comunicante , Governo Federal , Humanos , Distanciamento Físico , República da Coreia
8.
Sci Rep ; 11(1): 21174, 2021 10 27.
Artigo em Inglês | MEDLINE | ID: mdl-34707187

RESUMO

Lockdowns implemented to address the COVID-19 pandemic have disrupted human mobility flows around the globe to an unprecedented extent and with economic consequences which are unevenly distributed across territories, firms and individuals. Here we study socioeconomic determinants of mobility disruption during both the lockdown and the recovery phases in Italy. For this purpose, we analyze a massive data set on Italian mobility from February to October 2020 and we combine it with detailed data on pre-existing local socioeconomic features of Italian administrative units. Using a set of unsupervised and supervised learning techniques, we reliably show that the least and the most affected areas persistently belong to two different clusters. Notably, the former cluster features significantly higher income per capita and lower income inequality than the latter. This distinction persists once the lockdown is lifted. The least affected areas display a swift (V-shaped) recovery in mobility patterns, while poorer, most affected areas experience a much slower (U-shaped) recovery: as of October 2020, their mobility was still significantly lower than pre-lockdown levels. These results are then detailed and confirmed with a quantile regression analysis. Our findings show that economic segregation has, thus, strengthened during the pandemic.


Assuntos
COVID-19/epidemiologia , Pandemias , SARS-CoV-2 , COVID-19/economia , Controle de Doenças Transmissíveis/economia , Controle de Doenças Transmissíveis/métodos , Humanos , Renda , Itália/epidemiologia , Aprendizado de Máquina , Pandemias/economia , Pobreza , Quarentena/economia , Análise de Regressão , Fatores Socioeconômicos , Viagem
9.
PLoS One ; 16(9): e0256921, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34525120

RESUMO

Using a nationwide survey of primary grocery shoppers conducted in August 2020, we examine household food spending when the economy had partially reopened and consumers had different spending opportunities in comparison to when the Covid-19 lockdown began. We estimate the impact of Covid-19 on household spending using interval and Order Probit regressions. Income levels, age, access to grocery stores and farmers markets, household demographic information, along with other independent variables are controlled in the model. Findings show that middle-class households (with income below $50,000, or with income between $50,000 and $99,999) are less likely to increase their grocery expenditures during the pandemic. Households with children or elderlies that usually require higher food quality and nutrition intakes had a higher probability of increasing their spending during Covid-19 than before. Furthermore, consumers' spending behaviors were also significantly affected by their safe handing levels and the Covid-19 severity and food accessibility in their residences.


Assuntos
COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/economia , Características da Família , Alimentos/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Idoso , COVID-19/epidemiologia , COVID-19/virologia , Criança , Comportamento do Consumidor/estatística & dados numéricos , Custos e Análise de Custo , Epidemias/prevenção & controle , Habitação/normas , Habitação/estatística & dados numéricos , Humanos , Renda/estatística & dados numéricos , SARS-CoV-2/fisiologia , Fatores de Tempo , Estados Unidos
10.
PLoS One ; 16(9): e0256103, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34516549

RESUMO

How do people balance concerns for general health and economic outcomes during a pandemic? And, how does the communication of this trade-off affect individual preferences? We address these questions using a field experiment involving around 2000 students enrolled in a large university in Italy. We design four treatments where the trade-off is communicated using different combinations of a positive framing that focuses on protective strategies and a negative framing which refers to potential costs. We find that positive framing on the health side induces students to give greater relevance to the health dimension. The effect is sizeable and highly effective among many different audiences, especially females. Importantly, this triggers a higher level of intention to adhere to social distancing and precautionary behaviors. Moreover, irrespective of the framing, we find a large heterogeneity in students' preferences over the trade-off. Economics students and students who have directly experienced the economic impact of the pandemic are found to give greater value to economic outcomes.


Assuntos
COVID-19/psicologia , Controle de Doenças Transmissíveis/economia , Custos e Análise de Custo , Comunicação Persuasiva , Atitude , COVID-19/economia , COVID-19/prevenção & controle , Tomada de Decisões , Educação em Saúde/métodos , Humanos
12.
Nat Immunol ; 22(7): 797-798, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34035525
14.
Hosp Pract (1995) ; 49(4): 232-239, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33866912

RESUMO

The COVID-19 pandemic caused the United States to hit record numbers of COVID-19 cases: peak unemployment of 14.7%, an increase in $4 trillion in national debt, and an estimated 3.4% GDP decline. The current socio-economic environment the pandemic created is just an earthquake that can create a tsunami that is bound to hit the healthcare system and can be felt around the globe. This tsunami is composed of a post-pandemic increase in healthcare facilities admission of indigent patients, decrease in medical reimbursement, and high operating costs to maintain healthcare workers, which can cause a synergistic effect that can lead to healthcare facilities experiencing significant negative total revenue. Time is of the essence, and it is imperative to make a collective effort from all healthcare professionals and legislatures to shift the nation's attention to the issue at hand that can threaten the closure of many healthcare facilities post-pandemic.


Assuntos
COVID-19/economia , COVID-19/epidemiologia , Setor de Assistência à Saúde/organização & administração , COVID-19/prevenção & controle , Vacinas contra COVID-19/provisão & distribuição , Controle de Doenças Transmissíveis/economia , Recessão Econômica/estatística & dados numéricos , Setor de Assistência à Saúde/economia , Gastos em Saúde/estatística & dados numéricos , Humanos , Pandemias , Pobreza , SARS-CoV-2 , Fatores Socioeconômicos , Estados Unidos/epidemiologia
15.
J Gerontol Soc Work ; 64(6): 613-628, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33882781

RESUMO

The novel COVID-19 pandemic and its containment measures such as lockdown and physical distancing are remarkedly affecting older adults' economic activities and well-being in ways deserving of urgent attention. To strengthen caregiving and promote targeted care for older adults during and after the pandemic, this paper investigates the impact of the coronavirus on the economic activities and well-being of older adults in Enugu and Anambra states, Nigeria. Hermeneutic phenomenology was adopted and 16 older adults aged between 60 and 81 years, with a majority of them still working as farmers and traders were phone-interviewed. Findings highlighted four key lessons for gerontological social workers including 1) the fear that impact of the containment measures could kill the older adults faster than the virus; 2) the measures generate a feeling of neglect and marginalization of healthcare needs among older adults; 3) altered positive health-seeking behavior among the older adults; 4) and concern about the absence of functional policy and plan to address the welfare of older adults. Therefore, the central focus of the gerontological social workers and Nigerian polity should not be on how to reduce the spread of the disease alone, but on an application of caution in instituting and implementing the measures.


Assuntos
COVID-19/economia , COVID-19/epidemiologia , Controle de Doenças Transmissíveis/economia , Idoso , Idoso de 80 Anos ou mais , Medo , Feminino , Insegurança Alimentar , Humanos , Entrevistas como Assunto , Masculino , Saúde Mental , Pessoa de Meia-Idade , Nigéria/epidemiologia , Pandemias , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Assistência Pública/organização & administração , Pesquisa Qualitativa , SARS-CoV-2 , Assistentes Sociais/educação , Fatores Socioeconômicos
16.
PLoS One ; 16(4): e0248818, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33852593

RESUMO

The implementation of large-scale containment measures by governments to contain the spread of the COVID-19 virus has resulted in large impacts to the global economy. Here, we derive a new high-frequency indicator of economic activity using empirical vessel tracking data, and use it to estimate the global maritime trade losses during the first eight months of the pandemic. We go on to use this high-frequency dataset to infer the effect of individual non-pharmaceutical interventions on maritime exports, which we use as a proxy of economic activity. Our results show widespread port-level trade losses, with the largest absolute losses found for ports in China, the Middle-East and Western Europe, associated with the collapse of specific supply-chains (e.g. oil, vehicle manufacturing). In total, we estimate that global maritime trade reduced by -7.0% to -9.6% during the first eight months of 2020, which is equal to around 206-286 million tonnes in volume losses and up to 225-412 billion USD in value losses. We find large sectoral and geographical disparities in impacts. Manufacturing sectors are hit hardest, with losses up to 11.8%, whilst some small islands developing states and low-income economies suffered the largest relative trade losses. Moreover, we find a clear negative impact of COVID-19 related school and public transport closures on country-wide exports. Overall, we show how real-time indicators of economic activity can inform policy-makers about the impacts of individual policies on the economy, and can support economic recovery efforts by allocating funds to the hardest hit economies and sectors.


Assuntos
COVID-19/economia , Comércio/economia , Quarentena/economia , COVID-19/epidemiologia , China/epidemiologia , Controle de Doenças Transmissíveis/economia , Controle de Doenças Transmissíveis/métodos , Economia , Europa (Continente)/epidemiologia , Governo , Humanos , Oriente Médio/epidemiologia , Pandemias/economia , SARS-CoV-2/isolamento & purificação , Navios/economia
18.
Sci Rep ; 11(1): 5043, 2021 03 03.
Artigo em Inglês | MEDLINE | ID: mdl-33658596

RESUMO

The current COVID-19 pandemic has impacted millions of people and the global economy. Tourism has been one the most affected economic sectors because of the mobility restrictions established by governments and uncoordinated actions from origin and destination regions. The coordination of restrictions and reopening policies could help control the spread of virus and enhance economies, but this is not an easy endeavor since touristic companies, citizens, and local governments have conflicting interests. We propose an evolutionary game model that reflects a collective risk dilemma behind these decisions. To this aim, we represent regions as players, organized in groups; and consider the perceived risk as a strict lock-down and null economic activity. The costs for regions when restricting their mobility are heterogeneous, given that the dependence on tourism of each region is diverse. Our analysis shows that, for both large populations and the EU NUTS2 case study, the existence of heterogeneous costs enhances global agreements. Furthermore, the decision on how to group regions to maximize the regions' agreement of the population is a relevant issue for decision makers to consider. We find out that a layout of groups based on similar costs of cooperation boosts the regions' agreements and avoid the risk of having a total lock-down and a negligible tourism activity. These findings can guide policy makers to facilitate agreements among regions to maximize the tourism recovery.


Assuntos
COVID-19/economia , Controle de Doenças Transmissíveis/métodos , Transmissão de Doença Infecciosa/prevenção & controle , Controle de Doenças Transmissíveis/economia , Transmissão de Doença Infecciosa/economia , Humanos , Modelos Estatísticos , Pandemias/economia , Fatores de Risco , SARS-CoV-2/patogenicidade , Turismo
19.
Malar J ; 20(1): 128, 2021 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-33663488

RESUMO

BACKGROUND: Seasonal malaria chemoprevention (SMC) is a strategy for malaria control recommended by the World Health Organization (WHO) since 2012 for Sahelian countries. The Mali National Malaria Control Programme adopted a plan for pilot implementation and nationwide scale-up by 2016. Given that SMC is a relatively new approach, there is an urgent need to assess the costs and cost effectiveness of SMC when implemented through the routine health system to inform decisions on resource allocation. METHODS: Cost data were collected from pilot implementation of SMC in Kita district, which targeted 77,497 children aged 3-59 months. Starting in August 2014, SMC was delivered by fixed point distribution in villages with the first dose observed each month. Treatment consisted of sulfadoxine-pyrimethamine and amodiaquine once a month for four consecutive months, or rounds. Economic and financial costs were collected from the provider perspective using an ingredients approach. Effectiveness estimates were based upon a published mathematical transmission model calibrated to local epidemiology, rainfall patterns and scale-up of interventions. Incremental cost effectiveness ratios were calculated for the cost per malaria episode averted, cost per disability adjusted life years (DALYs) averted, and cost per death averted. RESULTS: The total economic cost of the intervention in the district of Kita was US $357,494. Drug costs and personnel costs accounted for 34% and 31%, respectively. Incentives (payment other than salary for efforts beyond routine activities) accounted for 25% of total implementation costs. Average financial and economic unit costs per child per round were US $0.73 and US $0.86, respectively; total annual financial and economic costs per child receiving SMC were US $2.92 and US $3.43, respectively. Accounting for coverage, the economic cost per child fully adherent (receiving all four rounds) was US $6.38 and US $4.69, if weighted highly adherent, (receiving 3 or 4 rounds of SMC). When costs were combined with modelled effects, the economic cost per malaria episode averted in children was US $4.26 (uncertainty bound 2.83-7.17), US $144 (135-153) per DALY averted and US $ 14,503 (13,604-15,402) per death averted. CONCLUSIONS: When implemented at fixed point distribution through the routine health system in Mali, SMC was highly cost-effective. As in previous SMC implementation studies, financial incentives were a large cost component.


Assuntos
Amodiaquina/uso terapêutico , Antimaláricos/uso terapêutico , Controle de Doenças Transmissíveis/economia , Análise Custo-Benefício/estatística & dados numéricos , Malária/prevenção & controle , Pirimetamina/uso terapêutico , Sulfadoxina/uso terapêutico , Quimioprevenção/economia , Pré-Escolar , Combinação de Medicamentos , Humanos , Lactente , Mali , Estações do Ano
20.
Front Public Health ; 9: 620770, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33748065

RESUMO

Various measures have been taken in different countries to mitigate the Covid-19 epidemic. But, throughout the world, many citizens don't understand well how these measures are taken and even question the decisions taken by their government. Should the measures be more (or less) restrictive? Are they taken for a too long (or too short) period of time? To provide some quantitative elements of response to these questions, we consider the well-known SEIR model for the Covid-19 epidemic propagation and propose a pragmatic model of the government decision-making operation. Although simple and obviously improvable, the proposed model allows us to study the tradeoff between health and economic aspects in a pragmatic and insightful way. Assuming a given number of phases for the epidemic (namely, 4 in this paper) and a desired tradeoff between health and economic aspects, it is then possible to determine the optimal duration of each phase and the optimal severity level (i.e., the target transmission rate) for each of them. The numerical analysis is performed for the case of France but the adopted approach can be applied to any country. One of the takeaway messages of this analysis is that being able to implement the optimal 4-phase epidemic management strategy in France would have led to 1.05 million of infected people and a GDP loss of 231 billions € instead of 6.88 millions of infected and a loss of 241 billions €. This indicates that, seen from the proposed model perspective, the effectively implemented epidemic management strategy is good economically, whereas substantial improvements might have been obtained in terms of health impact. Our analysis indicates that the lockdown/severe phase should have been more severe but shorter, and the adjustment phase occurred earlier. Due to the natural tendency of people to deviate from the official rules, updating measures every month over the whole epidemic episode seems to be more appropriate.


Assuntos
COVID-19 , Controle de Doenças Transmissíveis/economia , Análise Custo-Benefício/economia , Tomada de Decisões , Governo , Modelos Estatísticos , COVID-19/economia , COVID-19/epidemiologia , França/epidemiologia , Nível de Saúde , Humanos , Quarentena , Fatores de Tempo
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