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2.
JAMA Netw Open ; 4(4): e217373, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33825836

RESUMO

Importance: An accurate understanding of the distributional implications of public health policies is critical for ensuring equitable responses to the COVID-19 pandemic and future public health threats. Objective: To identify and quantify the association of race/ethnicity-based, sex-based, and income-based inequities of state-specific lockdowns with 6 well-being dimensions in the United States. Design, Setting, and Participants: This pooled, repeated cross-sectional study used data from 14 187 762 households who participated in phase 1 of the population-representative US 2020 Household Pulse Survey (HPS). Households were invited to participate by email, text message, and/or telephone as many as 3 times. Data were collected via an online questionnaire from April 23 to July 21, 2020, and participants lived in all 50 US states and the District of Columbia. Exposures: Indicators of race/ethnicity, sex, and income and their intersections. Main Outcomes and Measures: Unemployment; food insufficiency; mental health problems; no medical care received for health problems; default on last month's rent or mortgage; and class cancellations with no distance learning. Race/ethnicity, sex, income, and their intersections were used to measure distributional implications across historically marginalized populations; state-specific, time-varying population mobility was used to measure lockdown intensity. Logistic regression models with pooled repeated cross-sections were used to estimate risk of dichotomous outcomes by social group, adjusted for confounding variables. Results: The 1 088 314 respondents (561 570 [51.6%; 95% CI, 51.4%-51.9%] women) were aged 18 to 88 years (mean [SD], 51.55 [15.74] years), and 826 039 (62.8%; 95% CI, 62.5%-63.1%) were non-Hispanic White individuals; 86 958 (12.5%; 95% CI, 12.4%-12.7%), African American individuals; 86 062 (15.2%; 95% CI, 15.0%-15.4%), Hispanic individuals; and 50 227 (5.6%; 95% CI, 5.5%-5.7%), Asian individuals. On average, every 10% reduction in mobility was associated with higher odds of unemployment (odds ratio [OR], 1.3; 95% CI, 1.2-1.4), food insufficiency (OR, 1.1; 95% CI, 1.1-1.2), mental health problems (OR, 1.04; 95% CI, 1.0-1.1), and class cancellations (OR, 1.1; 95% CI, 1.1-1.2). Across most dimensions compared with White men with high income, African American individuals with low income experienced the highest risks (eg, food insufficiency, men: OR, 3.3; 95% CI, 2.8-3.7; mental health problems, women: OR, 1.9; 95% CI, 1.8-2.1; medical care inaccessibility, women: OR, 1.7; 95% CI, 1.6-1.9; unemployment, men: OR, 2.8; 95% CI, 2.5-3.2; rent/mortgage defaults, men: OR, 5.7; 95% CI, 4.7-7.1). Other high-risk groups were Hispanic individuals (eg, unemployment, Hispanic men with low income: OR, 2.9; 95% CI, 2.5-3.4) and women with low income across all races/ethnicities (eg, medical care inaccessibility, non-Hispanic White women: OR, 1.8; 95% CI, 1.7-2.0). Conclusions and Relevance: In this cross-sectional study, African American and Hispanic individuals, women, and households with low income had higher odds of experiencing adverse outcomes associated with the COVID-19 pandemic and stay-at-home orders. Blanket public health policies ignoring existing distributions of risk to well-being may be associated with increased race/ethnicity-based, sex-based, and income-based inequities.


Assuntos
Controle de Doenças Transmissíveis/estatística & dados numéricos , Grupos de Populações Continentais/estatística & dados numéricos , Grupos Étnicos/estatística & dados numéricos , Renda/estatística & dados numéricos , Fatores Sexuais , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Características da Família , Feminino , Disparidades nos Níveis de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Desemprego/estatística & dados numéricos , Estados Unidos , Adulto Jovem
3.
Nutrients ; 13(3)2021 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-33802743

RESUMO

Due to the outbreak of coronavirus disease 2019 (COVID-19), the Chinese government implemented strict lockdown measures to control the spread of infection. The impact of the COVID-19 lockdown on eating habits and lifestyles in the general population is unclear. This cross-sectional study was conducted via an online survey to obtain an overview of the food access, food intake, and physical activity of Chinese residents during the initial stage of the COVID-19 lockdown, and to investigate the association between staying at home/working from home and changes in eating habits and lifestyles. A total of 2702 participants (70.7% women) were included. Most of the participants maintained their habitual diet, while 38.2% increased their snack intake, 54.3% reported reduced physical activity, and 45.5% had increased sleep duration. Most people (70.1%) reported no change in body weight, while 25.0% reported an increase. Always staying at home/working from home was associated with an increase in animal product, vegetable, fruit, mushroom, nut, water, and snack intake, as well as sleep duration and frequency of skipping breakfast (odds ratio (OR) 1.54, 1.62, 1.58, 1.53, 1.57, 1.52, 1.77, 2.29, and 1.76 respectively). Suggestions should be made to encourage people to reduce their snack intake, maintain the daily consumption of breakfast, and increase physical activity during future lockdown periods.


Assuntos
/psicologia , Controle de Doenças Transmissíveis , Comportamento Alimentar , Estilo de Vida , Adolescente , Adulto , China/epidemiologia , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/estatística & dados numéricos , Estudos Transversais , Dieta/psicologia , Dieta/estatística & dados numéricos , Ingestão de Alimentos/psicologia , Exercício Físico , Comportamento Alimentar/psicologia , Feminino , Abastecimento de Alimentos , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
4.
BMJ Glob Health ; 6(3)2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33722793

RESUMO

OBJECTIVE: To review the effectiveness of travel measures implemented during the early stages of the COVID-19 pandemic to inform changes on how evidence is incorporated in the International Health Regulations (2005) (IHR). DESIGN: We used an abbreviated Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols to identify studies that investigated the effectiveness of travel-related measures preprinted or published by 1 June 2020. RESULTS: We identified 29 studies, of which 26 were modelled. Thirteen studies investigated international measures, while 17 investigated domestic measures (one investigated both). There was a high level of agreement that the adoption of travel measures led to important changes in the dynamics of the early phases of the COVID-19 pandemic: the Wuhan measures reduced the number of cases exported internationally by 70%-80% and led to important reductions in transmission within Mainland China. Additional travel measures, including flight restrictions to and from China, may have led to additional reductions in the number of exported cases. Few studies investigated the effectiveness of measures implemented in other contexts. Early implementation was identified as a determinant of effectiveness. Most studies of international travel measures did not account for domestic travel measures thus likely leading to biased estimates. CONCLUSION: Travel measures played an important role in shaping the early transmission dynamics of the COVID-19 pandemic. There is an urgent need to address important evidence gaps and also a need to review how evidence is incorporated in the IHR in the early phases of a novel infectious disease outbreak.


Assuntos
Controle de Doenças Transmissíveis , Viagem , /epidemiologia , China , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/estatística & dados numéricos , Saúde Global , Humanos , Pandemias
5.
Mayo Clin Proc ; 96(4): 912-920, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33714601

RESUMO

OBJECTIVE: To assess the prevalence and characteristics of coronavirus disease 2019 (COVID-19) cases during the reopening period in older adults, given that little is known about the prevalence of COVID-19 after the stay-at-home order was lifted in the United States, nor the actual effects of adherence to recommended public health measures (RPHM) on the risk of COVID-19. PATIENTS AND METHODS: This was a cross-sectional study nested in a parent prospective cohort study, which followed a population-based sample of 2325 adults 50 years and older residing in southeast Minnesota to assess the incidence of viral infections. Participants were instructed to self-collect both nasal and oropharyngeal swabs, which were tested by reverse transcription polymerase chain reaction-based severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) assay between May 8, 2020, and June, 30, 2020. We assessed the prevalence of COVID-19 cases and characteristics of study subjects. RESULTS: A total of 1505 eligible subjects participated in the study whose mean age was 68 years, with 885 (59%) women, 32 (2%) racial/ethnic minorities, and 906 (60%) with high-risk conditions for influenza. The prevalence of other Coronaviridae (human coronavirus [HCoV]-229E, HCoV-NL63, and HCoV-OC43) during the 2019 to 2020 flu season was 109 (7%), and none tested positive for SARS-CoV-2. Almost all participants reported adhering to the RPHM (1,488 [99%] for social distancing, 1,438 [96%] for wearing mask in a public space, 1,476 [98%] for hand hygiene, and 1,441 (96%) for staying home mostly). Eighty-six percent of participants resided in a single-family home. CONCLUSION: We did not identify SARS-COV-2 infection in our study cohort. The combination of participants' behavior in following the RPHM and their living environment may considerably mitigate the risk of COVID-19.


Assuntos
Controle de Doenças Transmissíveis , Fidelidade a Diretrizes/estatística & dados numéricos , Saúde Pública , Idoso , /epidemiologia , /psicologia , /estatística & dados numéricos , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Controle de Doenças Transmissíveis/estatística & dados numéricos , Estudos Transversais , Transmissão de Doença Infecciosa/prevenção & controle , Feminino , Humanos , Masculino , Minnesota/epidemiologia , Prevalência , Saúde Pública/métodos , Saúde Pública/estatística & dados numéricos , Comportamento de Redução do Risco , Precauções Universais/métodos , Precauções Universais/estatística & dados numéricos , Virologia/métodos
6.
Proc Natl Acad Sci U S A ; 118(12)2021 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-33658331

RESUMO

We evaluate the impacts of implementing and lifting nonpharmaceutical interventions (NPIs) in US counties on the daily growth rate of COVID-19 cases and compliance, measured through the percentage of devices staying home, and evaluate whether introducing and lifting NPIs protecting selective populations is an effective strategy. We use difference-in-differences methods, leveraging on daily county-level data and exploit the staggered introduction and lifting of policies across counties over time. We also assess heterogenous impacts due to counties' population characteristics, namely ethnicity and household income. Results show that introducing NPIs led to a reduction in cases through the percentage of devices staying home. When counties lifted NPIs, they benefited from reduced mobility outside of the home during the lockdown, but only for a short period. In the long term, counties experienced diminished health and mobility gains accrued from previously implemented policies. Notably, we find heterogenous impacts due to population characteristics implying that measures can mitigate the disproportionate burden of COVID-19 on marginalized populations and find that selectively targeting populations may not be effective.


Assuntos
/epidemiologia , Controle de Doenças Transmissíveis/métodos , /economia , Controle de Doenças Transmissíveis/estatística & dados numéricos , Fidelidade a Diretrizes/estatística & dados numéricos , Política de Saúde/economia , Política de Saúde/tendências , Humanos , Pandemias , Fatores Socioeconômicos , Estados Unidos/epidemiologia
7.
Medicine (Baltimore) ; 100(10): e24749, 2021 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-33725830

RESUMO

BACKGROUND: During the COVID-19 pandemic, one of the frequently asked questions is which countries (or continents) are severely hit. Aside from using the number of confirmed cases and the fatality to measure the impact caused by COVID-19, few adopted the inflection point (IP) to represent the control capability of COVID-19. How to determine the IP days related to the capability is still unclear. This study aims to (i) build a predictive model based on item response theory (IRT) to determine the IP for countries, and (ii) compare which countries (or continents) are hit most. METHODS: We downloaded COVID-19 outbreak data of the number of confirmed cases in all countries as of October 19, 2020. The IRT-based predictive model was built to determine the pandemic IP for each country. A model building scheme was demonstrated to fit the number of cumulative infected cases. Model parameters were estimated using the Solver add-in tool in Microsoft Excel. The absolute advantage coefficient (AAC) was computed to track the IP at the minimum of incremental points on a given ogive curve. The time-to-event analysis (a.k.a. survival analysis) was performed to compare the difference in IPs among continents using the area under the curve (AUC) and the respective 95% confidence intervals (CIs). An online comparative dashboard was created on Google Maps to present the epidemic prediction for each country. RESULTS: The top 3 countries that were hit severely by COVID-19 were France, Malaysia, and Nepal, with IP days at 263, 262, and 262, respectively. The top 3 continents that were hit most based on IP days were Europe, South America, and North America, with their AUCs and 95% CIs at 0.73 (0.61-0.86), 0.58 (0.31-0.84), and 0.54 (0.44-0.64), respectively. An online time-event result was demonstrated and shown on Google Maps, comparing the IP probabilities across continents. CONCLUSION: An IRT modeling scheme fitting the epidemic data was used to predict the length of IP days. Europe, particularly France, was hit seriously by COVID-19 based on the IP days. The IRT model incorporated with AAC is recommended to determine the pandemic IP.


Assuntos
/epidemiologia , Controle de Doenças Transmissíveis/estatística & dados numéricos , Saúde Global/estatística & dados numéricos , Modelos Estatísticos , /mortalidade , Surtos de Doenças , Humanos , Pandemias
8.
J Med Internet Res ; 23(3): e24593, 2021 03 22.
Artigo em Inglês | MEDLINE | ID: mdl-33646963

RESUMO

BACKGROUND: Smoking is a plausible risk factor for COVID-19 progression and complications. Smoking cessation digital platforms transcend pandemic-driven social distancing and lockdown measures in terms of assisting smokers in their quit attempts. OBJECTIVE: This study aims to examine trends in the number of visitors, followers, and subscribers on smoking cessation digital platforms from January to April 2020 and to compare these traffic data to those observed during the same 4-month period in 2019. The examination of prepandemic and postpandemic trends in smoking cessation digital platform traffic can reveal whether interest in smoking cessation among smokers is attributable to the COVID-19 pandemic. METHODS: We obtained cross-sectional data from daily visitors on the SmokeFree website; the followers of six SmokeFree social media accounts; and subscribers to the SmokeFree SMS text messaging and mobile app interventions of the National Cancer Institute's SmokeFree.gov initiative platforms, which are publicly available to US smokers. Average daily percentage changes (ADPCs) were used to measure trends for the entire 2020 and 2019 study periods, whereas daily percentage changes (DPCs) were used to measure trends for each time segment of change within each 4-month period. Data analysis was conducted in May and June 2020. RESULTS: The number of new daily visitors on the SmokeFree website (between days 39 and 44: DPC=18.79%; 95% CI 5.16% to 34.19%) and subscribers to the adult-focused interventions QuitGuide (between days 11 and 62: DPC=1.11%; 95% CI 0.80% to 1.43%) and SmokeFreeTXT (between days 11 and 89: DPC=0.23%; 95% CI 0.004% to 0.47%) increased, but this was followed by declines in traffic. No comparable peaks were observed in 2019. The number of new daily subscribers to quitSTART (ie, the teen-focused intervention) trended downward in 2020 (ADPC=-1.02%; 95% CI -1.88% to -0.15%), whereas the overall trend in the number of subscribers in 2019 was insignificant (P=.07). The number of SmokeFree social media account followers steadily increased by <0.1% over the 4-month study periods in 2019 and 2020. CONCLUSIONS: Peaks in traffic on the SmokeFree website and adult-focused intervention platforms in 2020 could be attributed to an increased interest in smoking cessation among smokers during the COVID-19 pandemic. Coordinated campaigns, especially those for adolescents, should emphasize the importance of smoking cessation as a preventive measure against SARS-CoV-2 infection and raise awareness of digital smoking cessation platforms to capitalize on smokers' heightened interest during the pandemic.


Assuntos
/epidemiologia , Abandono do Hábito de Fumar/estatística & dados numéricos , Mídias Sociais/estatística & dados numéricos , /virologia , Controle de Doenças Transmissíveis/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Masculino , Pandemias , Abandono do Hábito de Fumar/métodos
9.
PLoS Comput Biol ; 17(3): e1008776, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33661890

RESUMO

In an epidemic, individuals can widely differ in the way they spread the infection depending on their age or on the number of days they have been infected for. In the absence of pharmaceutical interventions such as a vaccine or treatment, non-pharmaceutical interventions (e.g. physical or social distancing) are essential to mitigate the pandemic. We develop an original approach to identify the optimal age-stratified control strategy to implement as a function of the time since the onset of the epidemic. This is based on a model with a double continuous structure in terms of host age and time since infection. By applying optimal control theory to this model, we identify a solution that minimizes deaths and costs associated with the implementation of the control strategy itself. We also implement this strategy for three countries with contrasted age distributions (Burkina-Faso, France, and Vietnam). Overall, the optimal strategy varies throughout the epidemic, with a more intense control early on, and depending on host age, with a stronger control for the older population, except in the scenario where the cost associated with the control is low. In the latter scenario, we find strong differences across countries because the control extends to the younger population for France and Vietnam 2 to 3 months after the onset of the epidemic, but not for Burkina Faso. Finally, we show that the optimal control strategy strongly outperforms a constant uniform control exerted over the whole population or over its younger fraction. This improved understanding of the effect of age-based control interventions opens new perspectives for the field, especially for age-based contact tracing.


Assuntos
/epidemiologia , Modelos Biológicos , Pandemias/prevenção & controle , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Número Básico de Reprodução/estatística & dados numéricos , Burkina Faso/epidemiologia , Criança , Pré-Escolar , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/estatística & dados numéricos , Biologia Computacional , Busca de Comunicante/métodos , Busca de Comunicante/estatística & dados numéricos , Feminino , França/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Conceitos Matemáticos , Pessoa de Meia-Idade , Modelos Estatísticos , Pandemias/estatística & dados numéricos , Vietnã/epidemiologia , Adulto Jovem
12.
Respirology ; 26(4): 322-333, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33690946

RESUMO

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.


Assuntos
Controle de Doenças Transmissíveis , Ásia/epidemiologia , Australásia/epidemiologia , /fisiopatologia , /virologia , Defesa Civil/organização & administração , Controle de Doenças Transmissíveis/legislação & jurisprudência , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Controle de Doenças Transmissíveis/estatística & dados numéricos , Regulamentação Governamental , Humanos , Cooperação Internacional , /fisiologia
13.
BMC Public Health ; 21(1): 448, 2021 03 05.
Artigo em Inglês | MEDLINE | ID: mdl-33673812

RESUMO

BACKGROUND: COVID-19 continues to represent the single biggest challenge to contemporary community sport globally. Compliance with social distancing policies, strict return-to-play protocols, and COVID-19 specific training has, perhaps, forever changed the way that children and young people engage in organised sport. Within this context, and while many children and families seek to re-engage with community sport, we (researchers and sport practitioners) have an obligation to ask questions about how the pandemic has impacted youth sport, understand the short- and long-term consequences, and explore what (if any) opportunities can be seized to assist and improve future participation and retention. The aim of this paper was to present an in-depth exploration of the impact of COVID-19 on youth sport in South Australia. METHODS: Within an interpretive descriptive methodology, this qualitative investigation draws on rich, individual interview and focus group data with 39 youth (ages 15-18), parents, coaches, and sport administrators. A reflexive thematic analysis was undertaken, leading to the development of four substantive themes. RESULTS: We conceptualised the '4 Rs' to advance theoretical understandings about the pandemic's impact on youth sport, including the themes 'recognising struggle', 'reconnection', 're-engaging after restrictions, and 'reimagining sport'. The themes captured insights about a decline in mental wellbeing and physical activity, an increase in family connectedness, the challenge for sports to attract volunteers and participants back into sport, and the opportunities to reset values and philosophies underpinning the provision of youth sport. CONCLUSION: The findings provide valuable insight into the youth sport setting as a result of the global pandemic and suggest that families, sporting clubs and sporting organisations require additional resources and tools (for example, support for parents to facilitate their children's training at home during lockdown) to aid recovery efforts and to ensure the survival and prosperity of youth sport into the future.


Assuntos
/epidemiologia , Controle de Doenças Transmissíveis/estatística & dados numéricos , Quarentena/psicologia , Quarentena/estatística & dados numéricos , Esportes Juvenis/psicologia , Esportes Juvenis/estatística & dados numéricos , Adolescente , Austrália , Criança , Feminino , Grupos Focais , Humanos , Masculino , Pandemias/estatística & dados numéricos , Austrália do Sul/epidemiologia , Inquéritos e Questionários
14.
BMC Public Health ; 21(1): 449, 2021 03 05.
Artigo em Inglês | MEDLINE | ID: mdl-33673833

RESUMO

INTRODUCTION: The evidence is now unequivocal that people from Black and Minority Ethnic Backgrounds (BAME) living in the UK are disproportionately affected by covid-19. There is growing evidence that the reasons for this difference are multi-factorial and need further exploration. AIM: The aim of this study was to understand better, perceptions of risk and responses to covid-19 of members of the Muslim community living in the North West of England, and to understand the facilitators and barriers to adherence to restrictions and guidance measures. METHOD: A total of 47 participants took part in 25 in-depth qualitative interviews and four focus groups (n=22) that explored perceptions of risk and responses to risk from covid-19. Data were analysed thematically. FINDINGS: Participants were aware of the mechanism of transmission of covid-19 and took steps to mitigate risk of transmission including, observing a range of hygiene practices and following social distancing guidance. Increased risk of covid-19 for BAME populations was explained largely in terms of exposure to the virus due to the types of employment people from BAME populations are employed in. Limitations both within the working environment and more generally in public spaces, was identified as problematic for effective social distancing. The closure of mosques sent out a strong message about the seriousness of the virus and religious teachings reinforced hygiene and social distancing guidelines. CONCLUSION: Across society there are people that adhere to restrictions and guidelines and those that do not. Improving local information provision and communication pathways during times of the pandemic, could aid understanding of risk and promote adherence to social distancing restrictions.


Assuntos
Grupo com Ancestrais do Continente Africano/psicologia , Controle de Doenças Transmissíveis/estatística & dados numéricos , Grupos Étnicos/psicologia , Fidelidade a Diretrizes , Islamismo/psicologia , Grupos Minoritários/psicologia , Pandemias/prevenção & controle , Adulto , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Grupos Étnicos/estatística & dados numéricos , Feminino , Grupos Focais , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Grupos Minoritários/estatística & dados numéricos , Pesquisa Qualitativa , Comportamento de Redução do Risco , Reino Unido/epidemiologia
15.
BMC Public Health ; 21(1): 467, 2021 03 08.
Artigo em Inglês | MEDLINE | ID: mdl-33685420

RESUMO

BACKGROUND: In March 2020, the World Health Organization (WHO) declared COVID-19 a pandemic. Many countries in Sub-Saharan Africa, Uganda inclusive, implemented lockdowns, curfew, banning of both private and public transport systems, and mass gatherings to minimize spread. Social control measures for COVID-19 are reported to increase violence and discrimination globally, including in Uganda as some may be difficult to implement resulting in the heavy deployment of law enforcement. Media reports indicated that cases of violence and discrimination had increased in Uganda's communities following the lockdown. We estimated the incidence and factors associated with experiencing violence and discrimination among Ugandans during the COVID-19 lockdown to inform control and prevention measures. METHODS: In April 2020, we conducted a secondary analysis of cross-sectional data under the International Citizen Project (ICP) to assess adherence to public health measures and their impact on the COVID-19 outbreak in Uganda. We analyzed data on violence and discrimination from the ICP study. We performed descriptive statistics for all the participants' characteristics and created a binary outcome variable called experiencing violence and/or discrimination. We performed logistic regression analysis to identify the factors associated with experiencing violence and discrimination. RESULTS: Of the 1726 ICP study participants, 1051 (58.8%) were males, 841 (48.7%) were currently living with a spouse or partner, and 376 (21.8%) had physically attended work for more than 3 days in the past week. Overall, 145 (8.4%) experienced any form of violence and/or discrimination by any perpetrator, and 46 (31.7%) of the 145 reported that it was perpetrated by a law enforcement officer. Factors associated with experiencing violence or discrimination were: being male (AOR = 1.60 CI:1.10-2.33), having attended work physically for more than 3 days in the past week (AOR = 1.52 CI:1.03-2.23), and inability to access social or essential health services since the epidemic started (AOR = 3.10 CI:2.14-4.50). CONCLUSION: A substantial proportion of Ugandan residents experienced violence and/or discrimination during the COVID-19 lockdown, mostly perpetrated by law enforcement officers. We recommend mitigation of the collateral impact of lockdowns with interventions that focus on improving policing quality, ensuring continuity of essential services, and strengthening support systems for vulnerable groups including males.


Assuntos
/prevenção & controle , Controle de Doenças Transmissíveis/estatística & dados numéricos , Preconceito/psicologia , Violência/psicologia , Violência/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Preconceito/estatística & dados numéricos , Uganda/epidemiologia , Adulto Jovem
16.
BMC Public Health ; 21(1): 466, 2021 03 08.
Artigo em Inglês | MEDLINE | ID: mdl-33685426

RESUMO

BACKGROUND: The high prevalence and mortality of coronavirus disease 2019 (COVID-19) have made it the most important health and social challenge around the world. However, this disease can be largely prevented by adherence to hygienic principles and protective behaviors. It seems that identifying the processes involved in protective health behaviors can be effective in planning and implementing suitable interventions to encourage the community toward protective behaviors. Therefore, the present study aimed to predict the preventive behaviors of COVID-19 according to the Protection Motivation Theory (PMT). METHODS: This cross-sectional study was conducted over 2 months in Hormozgan Province, Iran. The study population consisted of all citizens above the age of 15 years. An online questionnaire was used to collect the data. The questionnaire link was available to the participants through social networks. The questionnaire consisted of two sections, including the demographic information and the PMT constructs. All statistical calculations and hypothesis testing were performed in SPSS Version 21 and AMOS Version 21. The significance level was considered to be 0.05 for hypothesis testing. RESULTS: A total of 2032 subjects, with the mean age of 34.84 ± 9.8 years (r = 15-98), participated in this study. Most of the participants were 31-40 years old, female (60.4%), married (72%), urban residents (87.3%), and employed (58.8%). The majority of them also had a bachelor's degree or higher (58.8%). Significant positive correlations were observed between the preventive behaviors of COVID-19 and the perceived vulnerability (r = 0.192, P < 0.001), perceived severity (r = 0.092, P < 0.001), response efficacy (r = 0.398, P < 0.001), self-efficacy (r = 0.497, P < 0.001), and protection motivation (r = 0.595, P < 0.001). On the other hand, significant negative correlations were found between the preventive behaviors of COVID-19 and maladaptive behavior rewards (r = - 0.243, P < 0.001) and perceived costs (r = - 0.121, P < 0.001). CONCLUSION: The present findings showed that maladaptive behavior reward and fear negatively predicted the protective behaviors. On the other hand, response efficacy and self-efficacy positively predicted the protective behaviors; the impact of self-efficacy was the strongest. Overall, the information provided in this study can contribute to health policymaking in Iran.


Assuntos
/prevenção & controle , Controle de Doenças Transmissíveis/estatística & dados numéricos , Medo , Fidelidade a Diretrizes/estatística & dados numéricos , Comportamentos Relacionados com a Saúde , Motivação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Atitude Frente a Saúde , Estudos Transversais , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Autoeficácia , Inquéritos e Questionários , Adulto Jovem
17.
Diabetes Res Clin Pract ; 173: 108682, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33539868

RESUMO

BACKGROUND: To minimize the spread of Coronavirus Disease-2019, Saudi Arabia imposed a nationwide lockdown for over 6 weeks. We examined the impact of lockdown on glycemic control in individuals with type 1 diabetes (T1D) using continuous glucose monitoring (CGM); and assessed whether changes in glycemic control differ between those who attended a telemedicine visit during lockdown versus those who did not. MATERIALS AND METHODS: Flash CGM data from 101 individuals with T1D were retrospectively evaluated. Participants were categorized into two groups: Attended a telemedicine visit during lockdown (n = 61) or did not attend (n = 40). Changes in CGM metrics from the last 2 weeks pre-lockdown period (Feb 25 - March 9, 2020) to the last 2 weeks of complete lockdown period (April 7-20, 2020) were examined in the two groups. RESULTS: Those who attended a telemedicine visit during the lockdown period had a significant improvement in the following CGM metrics by the end of lockdown: Average glucose (from 180 to 159 mg/dl, p < 0.01), glycemic management indicator (from 7.7 to 7.2%, p = 0.03), time in range (from 46 to 55%, p < 0.01), and time above range (from 48 to 35%, p < 0.01) without significant changes in time below range, number of daily scans or hypoglycemic events, and other indices. In contrast, there were no significant changes in any of the CGM metrics during lockdown in those who did not attend telemedicine. CONCLUSIONS: A six-week lockdown did not worsen, nor improve, glycemic control in individuals with T1D who did not attend a telemedicine visit. Whereas those who attended a telemedicine visit had a significant improvement in glycemic metrics; supporting the clinical effectiveness of telemedicine in diabetes care.


Assuntos
Glicemia/metabolismo , Controle de Doenças Transmissíveis , Diabetes Mellitus Tipo 1/sangue , Telemedicina , Adolescente , Adulto , Automonitorização da Glicemia/métodos , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/estatística & dados numéricos , Diabetes Mellitus Tipo 1/tratamento farmacológico , Diabetes Mellitus Tipo 1/epidemiologia , Surtos de Doenças , Feminino , /normas , Humanos , Hipoglicemiantes/uso terapêutico , Masculino , Avaliação de Programas e Projetos de Saúde , Quarentena/métodos , Quarentena/estatística & dados numéricos , Estudos Retrospectivos , Arábia Saudita/epidemiologia , Telemedicina/organização & administração , Telemedicina/estatística & dados numéricos , Adulto Jovem
18.
Nat Commun ; 12(1): 1090, 2021 02 17.
Artigo em Inglês | MEDLINE | ID: mdl-33597546

RESUMO

In response to the COVID-19 pandemic, countries have sought to control SARS-CoV-2 transmission by restricting population movement through social distancing interventions, thus reducing the number of contacts. Mobility data represent an important proxy measure of social distancing, and here, we characterise the relationship between transmission and mobility for 52 countries around the world. Transmission significantly decreased with the initial reduction in mobility in 73% of the countries analysed, but we found evidence of decoupling of transmission and mobility following the relaxation of strict control measures for 80% of countries. For the majority of countries, mobility explained a substantial proportion of the variation in transmissibility (median adjusted R-squared: 48%, interquartile range - IQR - across countries [27-77%]). Where a change in the relationship occurred, predictive ability decreased after the relaxation; from a median adjusted R-squared of 74% (IQR across countries [49-91%]) pre-relaxation, to a median adjusted R-squared of 30% (IQR across countries [12-48%]) post-relaxation. In countries with a clear relationship between mobility and transmission both before and after strict control measures were relaxed, mobility was associated with lower transmission rates after control measures were relaxed indicating that the beneficial effects of ongoing social distancing behaviours were substantial.


Assuntos
/transmissão , Controle de Doenças Transmissíveis/métodos , Pandemias/prevenção & controle , /isolamento & purificação , Algoritmos , /virologia , Controle de Doenças Transmissíveis/estatística & dados numéricos , Saúde Global , Humanos , Modelos Teóricos , Quarentena/métodos , /fisiologia
19.
Public Health ; 192: 37-44, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33611170

RESUMO

OBJECTIVES: This study evaluated the characteristics of individuals with voluntary behavioural changes (cancellation and postponement of bookings) during the early stages of the coronavirus disease 2019 (COVID-19) outbreak in Japan. In addition, the temporal trends of these changes were captured. STUDY DESIGN: A cross-sectional analysis and a time series analysis were conducted. METHODS: A nation-wide retrospective panel survey was conducted at the end of March 2020 (n = 1052). Odds ratios for cancellations/postponements with respect to individual characteristics were calculated in the analysis. To determine the temporal trend, the incidence ratios were compared throughout the time series analysis for four time periods: period 1, before the announcement of the Public Health Emergency of International Concern (PHEIC) from the World Health Organisation (WHO) (January 1-31); period 2, after the announcement of PHEIC (February 1-26); period 3, after the announcement of school closures by the Japanese government (February 27 - March 11); and period 4, after the announcement of the pandemic by the WHO (March 12-31). RESULTS: In total, 72% of respondents cancelled or postponed their bookings at least once, and about half of the changes occurred in period 3. Elderly individuals' changes in gatherings were, on average, 5.9 times (95% confidence interval [CI] 1.9-17.9) higher than those of young individuals. The incidence rate of change in gatherings during period 3 was 7.11 times (95% CI: 5.16-9.81) higher than in period 2 and 3.15 times (95% CI: 2.25-4.43) higher than in period 4. Significant interaction terms were observed in age and residential city size, but not sex, of the respondents. CONCLUSIONS: A significant proportion of the Japanese population voluntarily changed their behaviour during the early stages of the COVID-19 outbreak, and the government's announcement of school closures was a key trigger during this time.


Assuntos
Ansiedade/epidemiologia , Controle de Doenças Transmissíveis/estatística & dados numéricos , Medo/psicologia , Pandemias/prevenção & controle , Adulto , Idoso , /prevenção & controle , Estudos Transversais , Surtos de Doenças , Feminino , Humanos , Incidência , Japão/epidemiologia , Masculino , Saúde Pública , Estudos Retrospectivos , Adulto Jovem
20.
BMJ Open ; 11(1): e045794, 2021 01 31.
Artigo em Inglês | MEDLINE | ID: mdl-33518530

RESUMO

SETTING: The State of Qatar has had one of the highest COVID-19 infection rates globally and has used state-managed quarantine and isolation centres to limit the spread of infection. Quarantine and isolation have been shown to negatively affect the mental health of individuals. Qatar has a unique population, with around 90% of the population being economic migrants and a majority being blue-collar workers and labourers. OBJECTIVES: This study was carried out to evaluate the psychological impact of institutional isolation and quarantine during the COVID-19 pandemic outbreak in Qatar. The study also explored the sociodemographic correlates of this psychological impact. DESIGN, PARTICIPANTS AND INTERVENTION: A cross-sectional study involving 748 consenting individuals in institutional quarantine and isolation in Qatar during the months of June and July 2020 was carried out. Relevant sociodemographic data along with depressive and anxiety symptomatology scores were collected from consenting adults at these facilities. RESULTS: 37.4% (n=270) of respondents reported depressive symptoms and 25.9% (n=189) reported anxiety symptoms. The scores were higher for individuals in isolation facilities and higher for migrants from poor socioeconomic group (p<0.001 for both). Within this group, although worries about infection were widely reported, lack of contact with the family was cited as one of the most important sources of distress. Respondents reported that contact with the family and reliable information were important factors that helped during the duration of isolation and quarantine. CONCLUSIONS: Our study reported significantly elevated scores for depression and anxiety during institutional quarantine, which is in keeping with emerging evidence. However, in contrast to other studies reporting mostly from native populations, this study of a population with an overwhelming majority of immigrants highlights the special mental health needs of this specific group and can inform future healthcare policies.


Assuntos
Ansiedade , Controle de Doenças Transmissíveis , Depressão , Angústia Psicológica , Quarentena/psicologia , Adulto , Ansiedade/epidemiologia , Ansiedade/etiologia , /prevenção & controle , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/estatística & dados numéricos , Estudos Transversais , Demografia , Depressão/epidemiologia , Depressão/etiologia , Feminino , Humanos , Masculino , Saúde Mental/estatística & dados numéricos , Determinação de Necessidades de Cuidados de Saúde , Catar/epidemiologia , Fatores Socioeconômicos , Migrantes/psicologia
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