Evaluating the effects of shelter-in-place policies during the COVID-19 pandemic.

We estimate the effects of shelter-in-place (SIP) orders during the first wave of the COVID-19 pandemic. We do not find detectable effects of these policies on disease spread or deaths. We find small but measurable effects on mobility that dissipate over time. And we find small, delayed effects on unemployment. We conduct additional analyses that separately assess the effects of expanding versus withdrawing SIP orders and test whether there are spillover effects in other states. Our results are consistent with prior studies showing that SIP orders have accounted for a relatively small share of the mobility trends and economic disruptions associated with the pandemic. We reanalyze two prior studies purporting to show that SIP orders caused large reductions in disease prevalence, and show that those results are not reliable. Our results do not imply that social distancing behavior by individuals, as distinct from SIP policy, is ineffective.

Consequences of a large-scale nuclear accident and guidelines for evacuation: a cost-effectiveness analysis.

PURPOSE: We aimed for a quantitative evaluation that justifies guidelines for evacuation which take into consideration both the human and economic costs. To the best of our knowledge, such an evaluation has not been performed yet. The present guidelines published by the International Atomic Energy Agency (IAEA) are probably based on averting radiation risk only; IAEA did not cite any quantitative estimation of the human cost of evacuation. MATERIALS AND METHODS: Quantitative estimation of the human and monetary costs of evacuation and, alternatively, the human and monetary costs of radiation exposure (non-evacuation). Associating human life with monetary value is psychologically difficult and somewhat challenging ethically; however, there is no escape from such an association (cost-effectiveness analysis) when making decisions regarding public health and safety, since extraneous public expenditures lead to a statistical life shortening. Estimating worst-case health consequences of irradiation, we used the conservative linear no-threshold (LNT) model because this model is widely used in spite of its controversy. In our estimation of the human cost of evacuation, we considered three factors: (a) direct loss of life (after Fukushima, 1% of the evacuees died within 2 years due to causes directly related to their evacuation), (b) loss of quality of life, and (c) loss of wealth leading to loss of life. The connection of economic loss with loss of life was performed according to the median cost-effectiveness threshold of 50-100 thousand USD per quality-adjusted life year. RESULTS: Even according to mortality calculations based on LNT, the overall loss of life due to evacuation is higher than the loss of life due to irradiation if the population-averaged first-year radiation dose is 500 mSv or less. CONCLUSIONS: Based on the performed analysis, we suggest avoiding evacuation if the projected first-year dose is below 500 mSv. This suggested action level is about five-fold higher than the action level presently recommended by the IAEA (100 mSv per year).

Development of emergency food assistance design: a nutritionally balanced, culturally tailored and cost-effective strategy for flood mitigation.

Emergency food assistance forms an integral component of flood mitigation in Malaysia. A cross-sectional survey investigating emergency food assistance among 202 flood victims was conducted and alternative food assistance plan was developed using linear programming targeting post-disaster food requirement scenarios. From the study, the receipt of food aid was significantly associated with ethnicity, household income, residential area and evacuation into temporary shelters. Linear programming analysis identified nutritionally appropriate food assistance targeting mass feeding, emergency food basket, and immediate food requirement for as low as MYR 6.07 (1.55 USD), MYR 7.14 (1.82 USD), and MYR 8.00 (2.04 USD), respectively. This study provides nutritional guidelines for disaster food assistance policy.

"Operation Pied Piper": a psychoanalytic narrative of authority in a time of war.

The evacuation of British children during World War II is read alongside the legend of the "Pied Piper" after which the mass migration was officially named. While virtually every British account of World War II makes mention of the evacuation, most are silent on the question of its ominous title: "Operation Pied Piper." This paper traces the legend's key theme - on influencing and being influenced - as it surfaces in the writing of one child analyst and one social worker charged with the responsibility of leading a family of five hostels for British youth. At a time when Hitler's deadly regime reached unprecedented heights across the Channel, the legend of the "Pied Piper" becomes a highly suggestive metaphor for thinking about D. W. Winnicott and Clare Britton's writing on what authority could mean in the face of leadership gone terribly wrong. Quite another, profoundly intimate loss of leadership haunts their words as well: Sigmund Freud, in exile from Hitler's Europe and leader of the psychoanalytic movement, died in London just weeks after the first wave of Blitz evacuations. It is in this context that Winnicott and Britton articulated a theory of authority that could address the losses of history without at the same time demanding the loss of the mind.