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1.
South Med J ; 114(10): 649-656, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34599344

RESUMO

OBJECTIVES: Although disparities in coronavirus disease 2019 (COVID-19) prevalence are known, knowledge of the recent surge of COVID-19 in Texas and factors affecting fatality rates is limited. Understanding the health disparities associated with COVID-19 can help healthcare professionals determine the populations that are most in need of COVID-19 preventive care and treatment. The aim of this study was to assess COVID-19-related case and mortality rates. METHODS: Our cross-sectional analysis used Texas Department of State Health Services COVID-19 case surveillance counts. Case, hospitalization, and mortality counts were obtained from March to July 2020. RESULTS: From March to July 2020, there were 420,397 COVID-19-related cases and 6954 deaths in Texas. There were 3277 new cases and 104 deaths in March, and 261,876 new cases and 3660 deaths in July. The number of new COVID-19 cases was the highest from March to April (relative risk 1.77, 95% confidence interval [CI] 1.76-1.78). Although the death rate in June was a 30% increase over the rate in May, death rates nearly tripled by the end of July, for a total of 3660 deaths. Of the 3958 deaths, demographic data were available for 753 deaths. Of these, 440 were male, 16 Asian, 95 Black, 221 Hispanic, 325 White, and 96 were "Other" or "Unknown." Males were associated with a slightly higher chance of acquiring COVID-19 than females (odds ratio [OR] 1.11, 95% CI 1.09-1.14) and nearly a 29% higher chance of dying of COVID-19 compared with females (OR 1.29, 95% CI 1.11-1.49). Bivariate analysis revealed that the probability of acquiring COVID-19 was 12% higher in older adults compared with individuals younger than 65 years old (OR 1.12, 95% CI 1.08-1.16), and older adults had an 18.8 times higher risk of death when compared with the rate of younger individuals (OR 18.79, 95% CI 15.93-22.15). Hispanics and Blacks were 70% and 48%, respectively, more likely to contract COVID-19 than Whites. All races had lower significant chance of death when compared with Whites. At the end of July, there was a total of 430,485 Texas COVID-19 cases and 6387 fatalities (8.8% of all cases and 4% of all deaths in the United States.). Case fatality ratios were the highest in older adults. As we continued to observe data, in contrast to previous study time points, we found that Asians and Hispanics had no significant difference in COVID mortality rates and were comparable in terms of mortality odds and death case ratios when compared with Whites. CONCLUSIONS: This time period represents the highest COVID-19 surge time in Texas. Although our data consist of a short time period of population-level data in an ongoing pandemic and are limited by information reported to the Texas Department of State Health Services, older age, male sex, Hispanics, and Blacks are currently associated with higher infection rates, whereas older age, male sex, and Whites are associated with higher mortality rates. Clinicians and decision makers should be aware of the COVID-19 health disparities and risk factors for mortality to better promote targeted interventions and allocate resources accordingly.


Assuntos
COVID-19/economia , Grupos de Populações Continentais/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , COVID-19/etnologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Fatores de Risco , Governo Estadual , Texas/epidemiologia
2.
PLoS One ; 16(9): e0256407, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34495996

RESUMO

The COVID-19 pandemic has profoundly impacted the economy and human lives worldwide, particularly the vulnerable low-income population. We employ a large panel data of 5.6 million daily transactions from 2.6 million debit cards owned by the low-income population in the U.S. to quantify the joint impacts of the state lockdowns and stimulus payments on this population's spending along the inter-temporal, geo-spatial, and cross-categorical dimensions. Leveraging the difference-in-differences analyses at the per card and zip code levels, we uncover three key findings. (1) Inter-temporally, the state lockdowns diminished the daily average spending relative to the same period in 2019 by $3.9 per card and $2,214 per zip code, whereas the stimulus payments elevated the daily average spending by $15.7 per card and $3,307 per zip code. (2) Spatial heterogeneity prevailed: Democratic zip codes displayed much more volatile dynamics, with an initial decline three times that of Republican zip codes, followed by a higher rebound and a net gain after the stimulus payments; also, Southwest exhibited the highest initial decline whereas Southeast had the largest net gain after the stimulus payments. (3) Across 26 categories, the stimulus payments promoted spending in those categories that enhanced public health and charitable donations, reduced food insecurity and digital divide, while having also stimulated non-essential and even undesirable categories, such as liquor and cigar. In addition, spatial association analysis was employed to identify spatial dependency and local hot spots of spending changes at the county level. Overall, these analyses reveal the imperative need for more geo- and category-targeted stimulus programs, as well as more effective and strategic policy communications, to protect and promote the well-being of the low-income population during public health and economic crises.


Assuntos
COVID-19/economia , Pandemias/economia , Pobreza/economia , Gastos em Saúde , Humanos , Distanciamento Físico , SARS-CoV-2/patogenicidade , Estados Unidos
3.
Sci Rep ; 11(1): 17680, 2021 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-34480045

RESUMO

The Covid-19 pandemic led to threatening shortages in healthcare of medical products such as face masks. Due to this major impact on our healthcare society an initiative was conducted between March and July 2020 for reprocessing of face masks from 19 different hospitals. This exceptional opportunity was used to study the costs impact and the carbon footprint of reprocessed face masks relative to new disposable face masks. The aim of this study is to conduct a Life Cycle Assessment (LCA) to assess and compare the climate change impact of disposed versus reprocessed face masks. In total 18.166 high quality medical FFP2 face masks were reprocessed through steam sterilization between March and July 2020. Greenhouse gas emissions during production, transport, sterilization and end-of-life processes were assessed. The background life cycle inventory data were retrieved from the ecoinvent database. The life cycle impact assessment method ReCiPe was used to translate emissions into climate change impact. The cost analysis is based on actual sterilization as well as associated costs compared to the prices of new disposable face masks. A Monte Carlo sampling was used to propagate the uncertainty of different inputs to the LCA results. The carbon footprint appears to be 58% lower for face masks which were reused for five times compared to new face masks which were used for one time only. The sensitivity analysis indicated that the loading capacity of the autoclave and rejection rate of face masks has a large influence on the carbon footprint. The estimated cost price of a reprocessed mask was €1.40 against €1.55. The Life Cycle Assessment demonstrates that reprocessed FFP2 face masks from a circular economy perspective have a lower climate change impact on the carbon footprint than new face masks. For policymakers it is important to realize that the carbon footprint of medical products such as face masks may be reduced by means of circular economy strategies. This study demonstrated a lower climate change impact and lower costs when reprocessing and reusing disposable face masks for five times. Therefore, this study may serve as an inspiration for investigating reprocessing of other medical products that may become scarce. Finally, this study advocates that circular design engineering principles should be taken into account when designing medical devices. This will lead to more sustainable products that have a lower carbon footprint and may be manufactured at lower costs.


Assuntos
COVID-19 , Reutilização de Equipamento/economia , Máscaras/economia , Pandemias , SARS-CoV-2 , Esterilização/economia , COVID-19/economia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Humanos
4.
Sci Rep ; 11(1): 17787, 2021 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-34493774

RESUMO

Despite COVID-19's significant morbidity and mortality, considering cost-effectiveness of pharmacologic treatment strategies for hospitalized patients remains critical to support healthcare resource decisions within budgetary constraints. As such, we calculated the cost-effectiveness of using remdesivir and dexamethasone for moderate to severe COVID-19 respiratory infections using the United States health care system as a representative model. A decision analytic model modelled a base case scenario of a 60-year-old patient admitted to hospital with COVID-19. Patients requiring oxygen were considered moderate severity, and patients with severe COVID-19 required intubation with intensive care. Strategies modelled included giving remdesivir to all patients, remdesivir in only moderate and only severe infections, dexamethasone to all patients, dexamethasone in severe infections, remdesivir in moderate/dexamethasone in severe infections, and best supportive care. Data for the model came from the published literature. The time horizon was 1 year; no discounting was performed due to the short duration. The perspective was of the payer in the United States health care system. Supportive care for moderate/severe COVID-19 cost $11,112.98 with 0.7155 quality adjusted life-year (QALY) obtained. Using dexamethasone for all patients was the most-cost effective with an incremental cost-effectiveness ratio of $980.84/QALY; all remdesivir strategies were more costly and less effective. Probabilistic sensitivity analyses showed dexamethasone for all patients was most cost-effective in 98.3% of scenarios. Dexamethasone for moderate-severe COVID-19 infections was the most cost-effective strategy and would have minimal budget impact. Based on current data, remdesivir is unlikely to be a cost-effective treatment for COVID-19.


Assuntos
COVID-19/tratamento farmacológico , COVID-19/terapia , Custos de Cuidados de Saúde/estatística & dados numéricos , Alocação de Recursos para a Atenção à Saúde/economia , Monofosfato de Adenosina/análogos & derivados , Monofosfato de Adenosina/economia , Monofosfato de Adenosina/uso terapêutico , Alanina/análogos & derivados , Alanina/economia , Alanina/uso terapêutico , COVID-19/diagnóstico , COVID-19/economia , COVID-19/mortalidade , COVID-19/virologia , Tomada de Decisão Clínica/métodos , Simulação por Computador , Análise Custo-Benefício , Dexametasona/economia , Dexametasona/uso terapêutico , Alocação de Recursos para a Atenção à Saúde/organização & administração , Humanos , Unidades de Terapia Intensiva/economia , Unidades de Terapia Intensiva/estatística & dados numéricos , Pessoa de Meia-Idade , Oxigênio/administração & dosagem , Oxigênio/economia , Anos de Vida Ajustados por Qualidade de Vida , Respiração Artificial/economia , SARS-CoV-2 , Índice de Gravidade de Doença , Resultado do Tratamento , Estados Unidos/epidemiologia
5.
Pan Afr Med J ; 39: 93, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34466195

RESUMO

Widespread vaccination provides a means for countries to lift strict COVID-19 restrictions previously imposed to contain the spread of the disease. However, to date, Africa has secured enough COVID-19 vaccine doses for less than 5% of its population. With widespread vaccination not on the horizon for Africa, there is a strong emphasis on non-pharmaceutical interventions which include movement restrictions (lockdowns). This general COVID-19 pandemic response of imposing lockdowns, however, neglects to factor in non-fatal consequences leading to disruption socio-economic wellbeing of the society at large. The economy in most African countries can no longer sustain lockdown restrictions. Some studies have indicated that a hard lockdown statistical value of the extra lives saved would be dwarfed by its long-term cost. At the same time not responding to the threat of the pandemic will cost lives and disrupts the social fabric. This paper proffers ways to mitigate the both and advocate for better policymaking that addresses specific challenges in defined communities thus yield higher population welfare.


Assuntos
Vacinas contra COVID-19/provisão & distribuição , COVID-19/prevenção & controle , Tecnologia Digital , Política de Saúde , África , COVID-19/economia , Humanos , Formulação de Políticas , Quarentena/economia , Fatores Socioeconômicos , Vacinação/estatística & dados numéricos
6.
Best Pract Res Clin Anaesthesiol ; 35(3): 293-306, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34511220

RESUMO

International hospitals and healthcare facilities are facing catastrophic financial challenges related to the COVID-19 pandemic. The American Hospital Association estimates a financial impact of $202.6 billion in lost revenue for America's hospitals and healthcare systems, or an average of $50.7 billion per month. Furthermore, it could cost low- and middle-income countries ~ US$52 billion (equivalent to US$8.60 per person) each four weeks to provide an effective healthcare response to COVID-19. In the setting of the largest daily COVID-19 new cases in the US, this burden will influence patient care, surgeries, and surgical outcomes. From a global economic standpoint, The World Bank projects that global growth is projected to shrink by almost 8% with poorer countries feeling most of the impact, and the United Nations projects that it will cost the global economy around 2 trillion dollars this year. Overall, a lack of preparedness was a major contributor to the struggles experienced by healthcare facilities around the world. Items such as personal protective equipment (PPE) for healthcare workers, hospital equipment, sanitizing supplies, toilet paper, and water were in short supply. These deficiencies were exposed by COVID-19 and have prompted healthcare organizations around the world to invent new essential plans for pandemic preparedness. In this paper, we will discuss the economic impact of COVID-19 on US and international hospitals, healthcare facilities, surgery, and surgical outcomes. In the future, the US and countries around the world will benefit from preparing a plan of action to use as a guide in the event of a disaster or pandemic.


Assuntos
COVID-19/economia , COVID-19/epidemiologia , Efeitos Psicossociais da Doença , Atenção à Saúde/economia , Saúde Global/economia , COVID-19/terapia , Atenção à Saúde/tendências , Saúde Global/tendências , Pessoal de Saúde/economia , Pessoal de Saúde/tendências , Humanos , Pandemias , Equipamento de Proteção Individual/economia , Equipamento de Proteção Individual/tendências , Estados Unidos/epidemiologia
7.
Best Pract Res Clin Anaesthesiol ; 35(3): 369-376, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34511225

RESUMO

Hospitals face catastrophic financial challenges in light of the coronavirus disease 2019 (COVID-19) pandemic. Acute shortages in materials such as masks, ventilators, intensive care unit capacity, and personal protective equipment (PPE) are a significant concern. The future success of supply chain management involves increasing the transparency of where our raw materials are sourced, diversifying of our product resources, and improving our technology that is able to predict potential shortages. It is also important to develop a proactive budgeting strategy to meet supply demands through early designation of dependable roles to support organizations and through the education of healthcare staff. In this paper, we discuss supply chain management, governance and financing, emergency protocols, including emergency procurement and supply chain, supply chain gaps and how to address them, and the importance of communication in the times of crisis.


Assuntos
COVID-19/terapia , Gestão de Recursos da Equipe de Assistência à Saúde/métodos , Equipamentos e Provisões Hospitalares/provisão & distribuição , Equipamento de Proteção Individual/provisão & distribuição , COVID-19/economia , COVID-19/epidemiologia , Defesa Civil/economia , Defesa Civil/métodos , Gestão de Recursos da Equipe de Assistência à Saúde/economia , Equipamentos e Provisões Hospitalares/economia , Humanos , Equipamento de Proteção Individual/economia
8.
PLoS One ; 16(9): e0257806, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34591874

RESUMO

BACKGROUND: Most universities that re-open in the United States (US) for in-person instruction have implemented the Centers for Disease Prevention and Control (CDC) guidelines. The value of additional interventions to prevent the transmission of SARS-CoV-2 is unclear. We calculated the cost-effectiveness and cases averted of each intervention in combination with implementing the CDC guidelines. METHODS: We built a decision-analytic model to examine the cost-effectiveness of interventions to re-open universities. The interventions included implementing the CDC guidelines alone and in combination with 1) a symptom-checking mobile application, 2) university-provided standardized, high filtration masks, 3) thermal cameras for temperature screening, 4) one-time entry ('gateway') polymerase chain reaction (PCR) testing, and 5) weekly PCR testing. We also modeled a package of interventions ('package intervention') that combines the CDC guidelines with using the symptom-checking mobile application, standardized masks, gateway PCR testing, and weekly PCR testing. The direct and indirect costs were calculated in 2020 US dollars. We also provided an online interface that allows the user to change model parameters. RESULTS: All interventions averted cases of COVID-19. When the prevalence of actively infectious cases reached 0.1%, providing standardized, high filtration masks saved money and improved health relative to implementing the CDC guidelines alone and in combination with using the symptom-checking mobile application, thermal cameras, and gateway testing. Compared with standardized masks, weekly PCR testing cost $9.27 million (95% Credible Interval [CrI]: cost-saving-$77.36 million)/QALY gained. Compared with weekly PCR testing, the 'package' intervention cost $137,877 (95% CrI: $3,108-$19.11 million)/QALY gained. At both a prevalence of 1% and 2%, the 'package' intervention saved money and improved health compared to all the other interventions. CONCLUSIONS: All interventions were effective at averting infection from COVID-19. However, when the prevalence of actively infectious cases in the community was low, only standardized, high filtration masks clearly provided value.


Assuntos
COVID-19/prevenção & controle , COVID-19/economia , COVID-19/transmissão , Teste de Ácido Nucleico para COVID-19/economia , Análise Custo-Benefício , Humanos , Máscaras/economia , SARS-CoV-2/isolamento & purificação , Estados Unidos , Universidades
9.
PLoS One ; 16(9): e0252794, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34469450

RESUMO

While there has been much speculation on how the pandemic has affected work location patterns and home location choices, there is sparse evidence regarding the impacts that COVID-19 has had on amenity visits in American cities, which typically constitute over half of all urban trips. Using aggregate app-based GPS positioning data from smartphone users, this study traces the changes in amenity visits in Somerville, MA from January 2019 to December 2020, describing how visits to particular types of amenities have changed as a result of business closures during the public health emergency. Has the pandemic fundamentally shifted amenity-oriented travel behavior or is consumer behavior returning to pre-pandemic trends? To address this question, we calibrate discrete choice models that are suited to Census block-group level analysis for each of the 24 months in a two-year period, and use them to analyze how visitors' behavioral responses to various attributes of amenity clusters have shifted during different phases of the pandemic. Our findings suggest that in the first few months of the pandemic, amenity-visiting preferences significantly diverged from expected patterns. Even though overall trip volumes remained far below normal levels throughout the remainder of the year, preferences towards specific cluster attributes mostly returned to expected levels by September 2020. We also construct two scenarios to explore the implications of another shutdown and a full reopening, based on November 2020 consumer behavior. While government restrictions have played an important role in reducing visits to amenity clusters, our results imply that cautionary consumer behavior has played an important role as well, suggesting a likely long and slow path to economic recovery. By drawing on mobile phone location data and behavioral modeling, this paper offers timely insights to help decision-makers understand how this unprecedented health emergency is affecting amenity-related trips and where the greatest needs for intervention and support may exist.


Assuntos
COVID-19 , Comportamento do Consumidor/economia , Pandemias/economia , SARS-CoV-2 , Smartphone , Viagem/economia , COVID-19/economia , COVID-19/epidemiologia , Cidades , Humanos , Massachusetts/epidemiologia , Estados Unidos
10.
PLoS One ; 16(9): e0256486, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34469468

RESUMO

This study aims to explore the impact of the Covid-19 pandemic on tourists' travel risk and management perceptions. Driven on the effect of the pandemic, we investigate tourists' travel risk and management perceptions and its effect on society using a sample of 716 respondents. The data was collected through social media platforms using a representative sampling method and analyzed applying the PLS-SEM tool. The findings reveal that Covid-19 pandemic has greatly affected travel risk and management perceptions. Travel risk and management perception had a significant association with risk management, service delivery, transportation patterns, distribution channels, avoidance of overpopulated destinations, and hygiene and safety. The results also identified the mediating effect of travel risk and management perceptions. The finding of this study contributes to tourism crises and provides future research insights in the travel and tourism sector and response to change tourists' travel risk and management perceptions in the post-covid recovery period.


Assuntos
COVID-19 , Pandemias , SARS-CoV-2 , Turismo , COVID-19/economia , COVID-19/epidemiologia , Feminino , Humanos , Masculino
11.
PLoS One ; 16(9): e0256879, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34499691

RESUMO

This paper uses event study based on the Generalized Autoregressive Conditional Heteroscedasticity (GARCH) model to study the impact of the COVID-19 outbreak on China's financial market. It finds that the pandemic had an overall significant and negative impact on the stock prices of firms listed on SSE, SZSE and ChiNext. However, such impact appeared to be heterogeneous across industries, affecting listed firms in industries such as pharmaceutical and telecommunications positively, but those in services industries such as accommodation, catering, and commercial services negatively. Apparently, a crisis for some had been an opportunity for others. In addition, this paper seeks to understand the micro mechanism behind the heterogeneity of pandemic shock from the perspective of firms' financial position. It finds that listed firms with higher debt level were hit harder, whereas those with more net cash flow had displayed higher resilience against the blow of the pandemic. However, the opposite pattern is found among those listed on ChiNext and in industries severely devastated by the pandemic. These findings have policy implications in terms of preventing systemic financial risks and facilitating recovery during pandemic-induced economic downturns. It also helps investor adjust investment strategies, hedge against risks, and secure gains when the market conditions in general are unfavorable.


Assuntos
COVID-19/economia , COVID-19/epidemiologia , Modelos Econômicos , China/epidemiologia , Administração Financeira , Indústrias , Investimentos em Saúde
12.
JAMA Netw Open ; 4(9): e2125187, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34581798

RESUMO

Importance: COVID-19, caused by SARS-CoV-2 virus, has disproportionately affected Black and Hispanic communities in the US, which can be attributed to social factors including inconsistent public health messaging and suboptimal adoption of prevention efforts. Objectives: To identify behaviors and evaluate trends in COVID-19-mitigating practices in a predominantly Black and Hispanic population, to identify differences in practices by self-reported ethnicity, and to evaluate whether federal emergency financial assistance was associated with SARS-CoV-2 acquisition. Design, Setting, and Participants: This survey study was conducted by telephone from July 1 through August 30, 2020, on a random sample of adults who underwent SARS-CoV-2 testing at a safety-net health care system in Chicago during the surge in COVID-19 cases in the spring of 2020. Behaviors and receipt of a stimulus check were compared between participants testing positive and negative for SARS-CoV-2. Differences in behaviors and temporal trends were assessed by race and ethnicity. Main Outcomes and Measures: SARS-CoV-2 infection was assessed using nasopharyngeal quantitative reverse transcriptase-polymerase chain reaction testing. Mitigating behaviors and federal emergency financial assistance were assessed by survey. Race and ethnicity data were collected from electronic health records. Results: Of 750 randomly sampled individuals, 314 (41.9%) consented to participate (169 [53.8%] women). Of those, 159 (51%) self-reported as Hispanic and 155 (49%) as non-Hispanic (120 [38.2%] Black), of whom 133 (84%) and 76 (49%) tested positive for SARS-CoV-2, respectively. For all participants, consistent mask use (public transport: adjusted odds ratio [aOR], 0.00; 95% CI, 0.00-0.34; social gatherings: aOR, 0.10; 95% CI, 0.00-0.50; running errands: aOR, 0.18; 95% CI, 0.07-0.42; at work: aOR, 0.23; 95% CI, 0.07-0.79) and hand sanitizer use (aOR, 0.26; 95% CI, 0.13-0.52) were associated with lower odds of infection. During 3 sampled weeks, mitigation practices were less frequent among Hispanic compared with non-Hispanic participants (eg, mask use while running errands: aOR, 0.26; 95% CI, 0.15-0.46). Hispanic participants were at high risk of infection (aOR, 5.52; 95% CI, 4.30-7.08) and more likely to work outside the home (aOR, 2.05; 95% CI, 1.27-3.30) compared with non-Hispanic participants, possibly because of limited receipt of stimulus checks (aOR, 0.03; 95% CI, 0.02-0.07) or unemployment benefits (aOR, 0.36; 95% CI, 0.16-0.74). Conclusions and Relevance: In this survey study of adults in a large US city, public health messaging improved preventive behaviors over time but lagged among Hispanic participants; messaging tailored to Hispanic communities, especially for mask use, should be prioritized. Hispanic individuals were at higher risk for infection, more often worked outside the home, and were less likely to have received a stimulus check; this suggests larger studies are needed to evaluate the provision of economic support on SARS-CoV-2 transmission dynamics in low-income populations.


Assuntos
Afro-Americanos , COVID-19/prevenção & controle , Grupos Étnicos , Comportamentos Relacionados com a Saúde/etnologia , Hispano-Americanos , Pandemias , População Urbana , Adulto , COVID-19/economia , COVID-19/etnologia , Chicago/epidemiologia , Estudos Transversais , Emprego , Feminino , Doações , Higienizadores de Mão , Inquéritos Epidemiológicos , Humanos , Masculino , Máscaras , Pessoa de Meia-Idade , Razão de Chances , Distanciamento Físico , Prevalência , SARS-CoV-2
14.
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
15.
PLoS One ; 16(9): e0257357, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34516564

RESUMO

BACKGROUND: Australia has maintained low rates of SARS-COV-2 (COVID-19) infection, due to geographic location and strict public health restrictions. However, the financial and social impacts of these restrictions can negatively affect parents' and children's mental health. In an existing cohort of mothers recruited for their experience of adversity, this study examined: 1) families' experiences of the COVID-19 pandemic and public health restrictions in terms of clinical exposure, financial hardship family stress, and family resilience (termed 'COVID-19 impacts'); and 2) associations between COVID-19 impacts and maternal and child mental health. METHODS: Participants were mothers recruited during pregnancy (2013-14) across two Australian states (Victoria and Tasmania) for the 'right@home' trial. A COVID-19 survey was conducted from May-December 2020, when children were 5.9-7.2 years old. Mothers reported COVID-19 impacts, their own mental health (Depression, Anxiety, Stress Scales short-form) and their child's mental health (CoRonavIruS Health and Impact Survey subscale). Associations between COVID-19 impacts and mental health were examined using regression models controlling for pre-COVID-19 characteristics. RESULTS: 319/406 (79%) mothers completed the COVID-19 survey. Only one reported having had COVID-19. Rates of self-quarantine (20%), job or income loss (27%) and family stress (e.g., difficulty managing children's at-home learning (40%)) were high. Many mothers also reported family resilience (e.g., family found good ways of coping (49%)). COVID-19 impacts associated with poorer mental health (standardised coefficients) included self-quarantine (mother: ß = 0.46, child: ß = 0.46), financial hardship (mother: ß = 0.27, child: ß = 0.37) and family stress (mother: ß = 0.49, child: ß = 0.74). Family resilience was associated with better mental health (mother: ß = -0.40, child: ß = -0.46). CONCLUSIONS: The financial and social impacts of Australia's public health restrictions have substantially affected families experiencing adversity, and their mental health. These impacts are likely to exacerbate inequities arising from adversity. To recover from COVID-19, policy investment should include income support and universal access to family health services.


Assuntos
COVID-19/psicologia , Saúde Mental , Mães/psicologia , Quarentena/psicologia , Adulto , COVID-19/economia , COVID-19/prevenção & controle , Criança , Efeitos Psicossociais da Doença , Feminino , Humanos , Masculino , Psicologia da Criança , Quarentena/economia , Resiliência Psicológica
16.
Sci Rep ; 11(1): 18626, 2021 09 20.
Artigo em Inglês | MEDLINE | ID: mdl-34545107

RESUMO

Population confinements have been one of the most widely adopted non-pharmaceutical interventions (NPIs) implemented by governments across the globe to help contain the spread of the SARS-CoV-2 virus. While confinement measures have been proven to be effective to reduce the number of infections, they entail significant economic and social costs. Thus, different policy makers and social groups have exhibited varying levels of acceptance of this type of measures. In this context, understanding the factors that determine the willingness of individuals to be confined during a pandemic is of paramount importance, particularly, to policy and decision-makers. In this paper, we study the factors that influence the unwillingness to be confined during the COVID-19 pandemic by the means of a large-scale, online population survey deployed in Spain. We perform two types of analyses (logistic regression and automatic pattern discovery) and consider socio-demographic, economic and psychological factors, together with the 14-day cumulative incidence per 100,000 inhabitants. Our analysis of 109,515 answers to the survey covers data spanning over a 5-month time period to shed light on the impact of the passage of time. We find evidence of pandemic fatigue as the percentage of those who report an unwillingness to be in confinement increases over time; we identify significant gender differences, with women being generally less likely than men to be able to sustain long-term confinement of at least 6 months; we uncover that the psychological impact was the most important factor to determine the willingness to be in confinement at the beginning of the pandemic, to be replaced by the economic impact as the most important variable towards the end of our period of study. Our results highlight the need to design gender and age specific public policies, to implement psychological and economic support programs and to address the evident pandemic fatigue as the success of potential future confinements will depend on the population's willingness to comply with them.


Assuntos
COVID-19/epidemiologia , Pandemias , Comportamento , COVID-19/economia , COVID-19/psicologia , Feminino , Humanos , Modelos Logísticos , Masculino , Razão de Chances , Reconhecimento Automatizado de Padrão , Espanha/epidemiologia , Estatística como Assunto , Inquéritos e Questionários , Local de Trabalho
19.
Plast Reconstr Surg ; 148(4): 899-906, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34495904

RESUMO

SUMMARY: In the wake of the death toll resulting from coronavirus disease of 2019 (COVID-19), in addition to the economic turmoil and strain on our health care systems, plastic surgeons are taking a hard look at their role in crisis preparedness and how they can contribute to crisis response policies in their own health care teams. Leaders in the specialty are charged with developing new clinical policies, identifying weaknesses in crisis preparation, and ensuring survival of private practices that face untenable financial challenges. It is critical that plastic surgery builds on the lessons learned over the past tumultuous year to emerge stronger and more prepared for subsequent waves of COVID-19. In addition, this global health crisis presents a timely opportunity to reexamine how plastic surgeons can display effective leadership during times of uncertainty and stress. Some may choose to emulate the traits and policies of leaders who are navigating the COVID-19 crisis effectively. Specifically, the national leaders who offer empathy, transparent communication, and decisive action have maintained high public approval throughout the COVID-19 crisis, while aggressively controlling viral spread. Crises are an inevitable aspect of modern society and medicine. Plastic surgeons can learn from this pandemic to better prepare for future turmoil.


Assuntos
COVID-19/prevenção & controle , Liderança , Papel Profissional , Cirurgia Plástica/organização & administração , COVID-19/economia , COVID-19/epidemiologia , COVID-19/transmissão , Controle de Doenças Transmissíveis/normas , Saúde Global , Humanos , Pandemias/economia , Pandemias/prevenção & controle , Equipe de Assistência ao Paciente/economia , Equipe de Assistência ao Paciente/organização & administração , SARS-CoV-2/patogenicidade , Cirurgiões/organização & administração , Cirurgia Plástica/economia , Incerteza
20.
Nutrients ; 13(9)2021 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-34578854

RESUMO

The coronavirus (COVID-19) pandemic has had serious repercussions on the global economy, work force, and food systems. In Lebanon, the pandemic overlapped with an economic crisis, which threatened to exacerbate food insecurity (FI). The present study aims to evaluate the trends and projections of FI in Lebanon due to overlapping health and economic crises. Data from Gallup World Poll (GWP) 2015-2017 surveys conducted in Lebanon on nationally representative adults (n = 3000) were used to assess FI trends and explore its sociodemographic correlates. Predictive models were performed to forecast trends in FI (2018-2022), using GWP data along with income reduction scenarios to estimate the impact of the pandemic and economic crises. Pre crises, trend analyses showed that FI could reach 27% considering wave year and income. Post crises, FI was estimated to reach on average 36% to 39%, considering 50-70% income reduction scenarios among Lebanese population. FI projections are expected to be higher among females compared to males and among older adults compared to younger ones (p < 0.05). These alarming findings call for emergency food security policies and evidence-based programs to mitigate the burden of multiple crises on the FI of Lebanese households and promote resilience for future shocks.


Assuntos
COVID-19/epidemiologia , Recessão Econômica/tendências , Insegurança Alimentar/economia , Abastecimento de Alimentos/estatística & dados numéricos , Pandemias/economia , Adolescente , Adulto , COVID-19/economia , COVID-19/psicologia , COVID-19/virologia , Estudos Transversais , Recessão Econômica/estatística & dados numéricos , Feminino , Abastecimento de Alimentos/economia , Humanos , Líbano/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pandemias/estatística & dados numéricos , Prevalência , Resiliência Psicológica , Fatores Socioeconômicos , Inquéritos e Questionários/estatística & dados numéricos , Adulto Jovem
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