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2.
South Med J ; 114(9): 597-602, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34480194

RESUMO

OBJECTIVES: Coronavirus disease 2019 (COVID-19) threatens vulnerable patient populations, resulting in immense pressures at the local, regional, national, and international levels to contain the virus. Laboratory-based studies demonstrate that masks may offer benefit in reducing the spread of droplet-based illnesses, but few data are available to assess mask effects via executive order on a population basis. We assess the effects of a county-wide mask order on per-population mortality, intensive care unit (ICU) utilization, and ventilator utilization in Bexar County, Texas. METHODS: We used publicly reported county-level data to perform a mixed-methods before-and-after analysis along with other sources of public data for analyses of covariance. We used a least-squares regression analysis to adjust for confounders. A Texas state-level mask order was issued on July 3, 2020, followed by a Bexar County-level order on July 15, 2020. We defined the control period as June 2 to July 2 and the postmask order period as July 8, 2020-August 12, 2020, with a 5-day gap to account for the median incubation period for cases; longer periods of 7 and 10 days were used for hospitalization and ICU admission/death, respectively. Data are reported on a per-100,000 population basis using respective US Census Bureau-reported populations. RESULTS: From June 2, 2020 through August 12, 2020, there were 40,771 reported cases of COVID-19 within Bexar County, with 470 total deaths. The average number of new cases per day within the county was 565.4 (95% confidence interval [CI] 394.6-736.2). The average number of positive hospitalized patients was 754.1 (95% CI 657.2-851.0), in the ICU was 273.1 (95% CI 238.2-308.0), and on a ventilator was 170.5 (95% CI 146.4-194.6). The average deaths per day was 6.5 (95% CI 4.4-8.6). All of the measured outcomes were higher on average in the postmask period as were covariables included in the adjusted model. When adjusting for traffic activity, total statewide caseload, public health complaints, and mean temperature, the daily caseload, hospital bed occupancy, ICU bed occupancy, ventilator occupancy, and daily mortality remained higher in the postmask period. CONCLUSIONS: There was no reduction in per-population daily mortality, hospital bed, ICU bed, or ventilator occupancy of COVID-19-positive patients attributable to the implementation of a mask-wearing mandate.


Assuntos
COVID-19/mortalidade , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/legislação & jurisprudência , Recursos em Saúde/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Controle de Doenças Transmissíveis/métodos , Implementação de Plano de Saúde , Política de Saúde , Humanos , Governo Local , Máscaras , SARS-CoV-2 , Texas/epidemiologia
3.
Isr J Health Policy Res ; 10(1): 52, 2021 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-34474685

RESUMO

OBJECTIVES: This study aimed at exploring the relationships between physical activity, weight control, and psycho-social aspects of the COVID-19 lockdown, which have characterized the Israeli population's behavior during the COVID-19 global crisis. DESIGN: Cross-sectional survey research. METHODS: Participants included 1855 men and women aged 18 and above, from different regions in the country and representing different sectors. They were recruited through the social media in a "snowball" sampling, and filled out a self-administered six-part survey: Demographic background, the International Physical Activity Questionnaire (IPAQ), the positive and negative affect scales (PANAS), the Conor and Davidson resilience scale, a questionnaire for measuring depressive symptoms, and questions regarding weight change based on the Israeli National Health and Nutrition (MABAT) survey. RESULTS: Routine physical activity (PA) was reported by 76.3% of the participants before the lockdown, 19.3% stopped exercising during this period, and 9.3% began exercising during the lockdown. The participants who were physically active during the lockdown period reported a higher level of resilience and positive feelings, and a lower level of depression, compared with those who were not physically active. People who were physically active during the lockdown maintained their weight compared with those who were inactive. Concerning weight change, 44.8% of the respondents maintained their weight, and a higher percentage of people reported weight gain than those who reported weight loss. CONCLUSIONS: Continuous PA before and during the COVID-19 lockdown were associated with higher resilience and positive emotions, and depressive symptoms, in people aged 18 and above. Although a causal link cannot be established, in light of the results of the present study, encouraging physical activity may contribute to improving mental health and a sense of self-efficacy, as well as to maintaining weight during a crisis.


Assuntos
Peso Corporal/fisiologia , COVID-19 , Exercício Físico/fisiologia , Saúde Mental , Adolescente , Adulto , Afeto , Idoso , Controle de Doenças Transmissíveis/métodos , Estudos Transversais , Emoções , Feminino , Humanos , Israel , Masculino , Pessoa de Meia-Idade , Resiliência Psicológica , Inquéritos e Questionários , Adulto Jovem
4.
Public Health Res Pract ; 31(3)2021 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-34494070

RESUMO

The emergence of the Delta variant of SARS-CoV-2 has made Australia's 'COVID-zero' strategy unviable. As signalled by the Australian Government's National plan to transition Australia's national COVID-19 response, we need to plan a pathway forward for life beyond lockdown. However, this plan must be guided by long overdue discussions on our tolerance for serious illness, and hospital and intensive care unit capacity. The modelling that informs the national transition plan remains relevant, even with increases in case numbers, but one crucial thing that does change if cases continue to escalate is the effectiveness of test, trace and isolate models. As we move into suppression mode with higher rates of the population fully vaccinated, we will no longer need to find every case. This is among the many shifts in approach that will shape our transition by early 2022 to living with - and controlling - the disease.


Assuntos
COVID-19/epidemiologia , Controle de Doenças Transmissíveis/métodos , Austrália/epidemiologia , COVID-19/prevenção & controle , Busca de Comunicante/métodos , Governo , Hospitalização/estatística & dados numéricos , Humanos , Modelos Teóricos , SARS-CoV-2
5.
Public Health Res Pract ; 31(3)2021 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-34494077

RESUMO

OBJECTIVES: To describe local operational aspects of the coronavirus disease 2019 (COVID-19) response during the first three waves of outbreaks in New South Wales (NSW), Australia, which began in January, July and December 2020. Type of program or service: Public health outbreak response. METHODS: Narrative with epidemiological linking and genomic testing. RESULTS: Epidemiological linking and genomic testing found that during the first wave of COVID-19 in NSW, a large number of community transmissions went undetected because of limited testing for the virus and limited contact tracing of cases. The second wave of COVID-19 in NSW emerged following reintroduction from the second wave in Victoria, Australia in July 2020, and the third wave followed undetected introduction from overseas. By the second and third waves, cases could be more effectively detected and isolated through an increased ability to test and contact trace, and to rapidly genomic sequence severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) isolates, allowing most cases to be identified and epidemiologically linked. This greater certainty in understanding chains of transmission resulted in control of the outbreaks despite less stringent restrictions on the community, by using a refined strategy of targeted shutdown, restrictions on cases, their close contacts, identified hotspots and venues of concern rather than a whole of community lockdown. Risk assessments of potential transmission sites were constantly updated through our evolving experience with transmission events. However, this refined strategy did leave the potential for large point source outbreaks should any cases go undetected. [Addendum] A fourth wave that began in Sydney in June 2021 challenged this strategy due to the more transmissible nature of the Delta variant of SARS-CoV-2. LESSONS LEARNT: A wave of COVID-19 infections can develop quickly from one infected person. The community needs to remain vigilant, adhering to physical distancing measures, signing in to venues they visit, and getting tested if they have any symptoms. Signing out of venues on exit allows public health resources to be used more efficiently to respond to outbreaks.


Assuntos
COVID-19/epidemiologia , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/métodos , Surtos de Doenças/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/diagnóstico , Teste para COVID-19/métodos , Criança , Pré-Escolar , Controle de Doenças Transmissíveis/organização & administração , Busca de Comunicante/métodos , Surtos de Doenças/prevenção & controle , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , New South Wales/epidemiologia , Distanciamento Físico , Saúde Pública , Quarentena/métodos , SARS-CoV-2/isolamento & purificação , Vitória/epidemiologia , Adulto Jovem
6.
J Foot Ankle Res ; 14(1): 53, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34470650

RESUMO

BACKGROUND: Occupational musculoskeletal injuries are prevalent in healthcare workers and are reported to be profession-specific. There is, however, a paucity of information around the injuries sustained from working as a podiatrist. This paper looks at the incidence of injury from working as a podiatrist, the aggravating factors to sustain these injuries and whether the changes in workload due to the COVID-19 pandemic altered the incidence. METHODS: A modified work based musculoskeletal injury questionnaire was distributed in the UK via podiatry led social media platforms. Open and Closed questions explored the demographics of the sample, perceived injury 12 months prior to the COVID-19 pandemic and then 6 months into the lockdown. Pre and post COVID-19 data were analysed for differences and thematic analysis was included to categorise reported experiences. RESULTS: 148 podiatrists representing 3 % of HCPC registered practitioners responded to the questionnaire. Employment status altered as a result of the COVID-19 pandemic with a 13 % reduction in those working full time. Environments also changed with domiciliary and telehealth significantly increasing (p > 0.00) and non-clinical roles being extended (p > 0.002). Pain frequency and intensity significantly (p > 0.04) increased as a result of the pandemic with shoulder pain being most frequent before lockdown altering to the neck during the lockdown. Two main themes were identified that were attributed to the causes of pain including physical demands and working in awkward spaces. CONCLUSIONS: Work-related musculoskeletal pain in podiatrists is common with the shoulder and neck being the most frequently affected. Changes in work practices due to the restrictions enforced from the COVID-19 pandemic increased the frequency and intensity of pain mostly associated with increased domiciliary and telehealth working environments.


Assuntos
Acidentes de Trabalho , COVID-19 , Cervicalgia , Doenças Profissionais , Podiatria , Dor de Ombro , Acidentes de Trabalho/prevenção & controle , Acidentes de Trabalho/estatística & dados numéricos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/métodos , Pesquisas sobre Serviços de Saúde/métodos , Pesquisas sobre Serviços de Saúde/estatística & dados numéricos , Humanos , Cervicalgia/epidemiologia , Cervicalgia/etiologia , Doenças Profissionais/classificação , Doenças Profissionais/epidemiologia , Podiatria/métodos , Podiatria/tendências , Prevalência , SARS-CoV-2 , Dor de Ombro/epidemiologia , Dor de Ombro/etiologia , Telemedicina/métodos , Reino Unido/epidemiologia , Carga de Trabalho/estatística & dados numéricos , Local de Trabalho/normas
7.
BMJ ; 374: n2060, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34470747

RESUMO

OBJECTIVE: To determine the risk of hospital admission with covid-19 and severe covid-19 among teachers and their household members, overall and compared with healthcare workers and adults of working age in the general population. DESIGN: Population based nested case-control study. SETTING: Scotland, March 2020 to July 2021, during defined periods of school closures and full openings in response to covid-19. PARTICIPANTS: All cases of covid-19 in adults aged 21 to 65 (n=132 420) and a random sample of controls matched on age, sex, and general practice (n=1 306 566). Adults were identified as actively teaching in a Scottish school by the General Teaching Council for Scotland, and their household members were identified through the unique property reference number. The comparator groups were adults identified as healthcare workers in Scotland, their household members, and the remaining general population of working age. MAIN OUTCOME MEASURES: The primary outcome was hospital admission with covid-19, defined as having a positive test result for SARS-CoV-2 during hospital admission, being admitted to hospital within 28 days of a positive test result, or receiving a diagnosis of covid-19 on discharge from hospital. Severe covid-19 was defined as being admitted to intensive care or dying within 28 days of a positive test result or assigned covid-19 as a cause of death. RESULTS: Most teachers were young (mean age 42), were women (80%), and had no comorbidities (84%). The risk (cumulative incidence) of hospital admission with covid-19 was <1% for all adults of working age in the general population. Over the study period, in conditional logistic regression models adjusted for age, sex, general practice, race/ethnicity, deprivation, number of comorbidities, and number of adults in the household, teachers showed a lower risk of hospital admission with covid-19 (rate ratio 0.77, 95% confidence interval 0.64 to 0.92) and of severe covid-19 (0.56, 0.33 to 0.97) than the general population. In the first period when schools in Scotland reopened, in autumn 2020, the rate ratio for hospital admission in teachers was 1.20 (0.89 to 1.61) and for severe covid-19 was 0.45 (0.13 to 1.55). The corresponding findings for household members of teachers were 0.91 (0.67 to 1.23) and 0.73 (0.37 to 1.44), and for patient facing healthcare workers were 2.08 (1.73 to 2.50) and 2.26 (1.43 to 3.59). Similar risks were seen for teachers in the second period, when schools reopened in summer 2021. These values were higher than those seen in spring/summer 2020, when schools were mostly closed. CONCLUSION: Compared with adults of working age who are otherwise similar, teachers and their household members were not found to be at increased risk of hospital admission with covid-19 and were found to be at lower risk of severe covid-19. These findings should reassure those who are engaged in face-to-face teaching.


Assuntos
COVID-19/epidemiologia , Pessoal de Saúde/estatística & dados numéricos , Professores Escolares/estatística & dados numéricos , Adulto , Idoso , Estudos de Casos e Controles , Controle de Doenças Transmissíveis/métodos , Conjuntos de Dados como Assunto , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Medição de Risco , SARS-CoV-2 , Escócia/epidemiologia , Adulto Jovem
8.
JAMA Netw Open ; 4(9): e2123405, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34473257

RESUMO

Importance: Mass incarceration is known to foster infectious disease outbreaks, amplification of infectious diseases in surrounding communities, and exacerbation of health disparities in disproportionately policed communities. To date, however, policy interventions intended to achieve epidemic mitigation in US communities have neglected to account for decarceration as a possible means of protecting public health and safety. Objective: To evaluate the association of jail decarceration and government anticontagion policies with reductions in the spread of SARS-CoV-2. Design, Setting, and Participants: This cohort study used county-level data from January to November 2020 to analyze COVID-19 cases, jail populations, and anticontagion policies in a panel regression model to estimate the association of jail decarceration and anticontagion policies with COVID-19 growth rates. A total of 1605 counties with data available on both jail population and COVID-19 cases were included in the analysis. This sample represents approximately 51% of US counties, 72% of the US population, and 60% of the US jail population. Exposures: Changes to jail populations and implementation of 10 anticontagion policies: nursing home visitation bans, school closures, mask mandates, prison visitation bans, stay-at-home orders, and closure of nonessential businesses, gyms, bars, movie theaters, and restaurants. Main Outcomes and Measures: Daily COVID-19 case growth rates. Results: In the 1605 counties included in this study, the mean (SD) prison population was 283.38 (657.78) individuals, and the mean (SD) population was 315.24 (2151.01) persons per square mile. An estimated 80% reduction in US jail populations, achievable through noncarceral management of nonviolent alleged offenses and in line with average international incarceration rates, would have been associated with a 2.0% (95% CI, 0.8%-3.1%) reduction in daily COVID-19 case growth rates. Jail decarceration was associated with 8 times larger reductions in COVID-19 growth rates in counties with above-median population density (4.6%; 95% CI, 2.2%- 7.1%) relative to those below this median (0.5%; 95% CI, 0.1%-0.9%). Nursing home visitation bans were associated with a 7.3% (95% CI, 5.8%-8.9%) reduction in COVID-19 case growth rates, followed by school closures (4.3%; 95% CI, 2.0%-6.6%), mask mandates (2.5%; 95% CI, 1.7%-3.3%), prison visitation bans (1.2%; 95% CI, 0.2%-2.2%), and stay-at-home orders (0.8%; 95% CI, 0.1%-1.6%). Conclusions and Relevance: Although many studies have documented that high incarceration rates are associated with communitywide health harms, this study is, to date, the first to show that decarceration is associated with population-level public health benefits. Its findings suggest that, among other anticontagion interventions, large-scale decarceration and changes to pretrial detention policies are likely to be important for improving US public health, biosecurity, and pandemic preparedness.


Assuntos
COVID-19/epidemiologia , Controle de Doenças Transmissíveis/métodos , Prisões Locais/organização & administração , Prisioneiros/estatística & dados numéricos , Estudos de Coortes , Controle de Doenças Transmissíveis/legislação & jurisprudência , Controle de Doenças Transmissíveis/estatística & dados numéricos , Humanos , Pandemias , SARS-CoV-2 , Estados Unidos
9.
JAMA Netw Open ; 4(9): e2124092, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34477850

RESUMO

Importance: In-person schooling has been disrupted for most school-aged youth during the COVID-19 pandemic, with low-income, Black, and Hispanic populations most likely to receive fully remote instruction. Disruptions to in-person schooling may have negatively and inequitably affected children's mental health. Objective: To estimate the association between school closures and child mental health outcomes and how it varies across sociodemographic factors. Design, Setting, and Participants: This cross-sectional population-based survey study included a nationally representative sample of US adults aged 18 to 64 years with at least 1 child in the household. The survey was administered between December 2 and December 21, 2020, via web and telephone in English and Spanish. Participants were recruited from the NORC AmeriSpeak panel, an address-based panel with known probability sampling and coverage of 97% of US households. Exposures: Schooling modality (in person, fully remote, or hybrid), household income, age. Main Outcomes and Measures: Child mental health difficulties were measured with the parent-report version of the Strengths and Difficulties Questionnaire, with small, medium, and large effect sizes defined as 1.3-, 3.3-, and 5.2-point differences, respectively. Results: A total of 2324 adults completed the survey. Overall, 1671 respondents (71.9%) were women, 244 (10.5%) were Black, 372 (16.0%) were Hispanic, and 421 (18.1%) had a high school education or less. Children attending school in-person had higher household incomes (mean difference, $9719; 95% CI, $4327 to $15 111; P < .001) and were more likely to be White compared with those attending remotely (366 of 556 [65.8%] vs 597 of 1340 [44.5%]; P < .001). Older children in remote schooling had more mental health difficulties than those attending in-person schooling (standardized effect size, 0.23 [95% CI, 0.07 to 0.39] per year older; P = .006), corresponding to small effect sizes in favor of in-person schooling for older children and very small effect sizes favoring remote schooling for younger children. Children from families with higher income benefitted more from attending schools in-person compared with their peers from families with lower income (B = -0.20 [95% CI, -0.10 to -0.30] per $10 000-increase in annual income; P < .001), although this advantage was not apparent for children attending hybrid school (B = -0.05 [95% CI, -0.16 to 0.06] per $10 000-increase in annual income; P = .34), and directionally lower but not significantly different for children attending remote school (B = -0.12 [95% CI, -0.04 to -0.20] per $10 000-increase in annual income; P < .001). Learning pods fully buffered the associations of hybrid schooling (d = -0.25; 95% CI, -0.47 to -0.04) but not remote schooling (d = 0.04; 95% CI, -0.10 to 0.18) with negative mental health outcomes. Conclusions and Relevance: The findings of this study suggest that older and Black and Hispanic children as well as those from families with lower income who attend school remotely may experience greater impairment to mental health than their younger, White, and higher-income counterparts. Ensuring that all students have access to additional educational and mental health resources must be an important public health priority, met with appropriate funding and workforce augmentation, during and beyond the COVID-19 pandemic.


Assuntos
Controle de Doenças Transmissíveis/métodos , Saúde Mental , Instituições Acadêmicas/organização & administração , Estudantes/psicologia , Adolescente , Adulto , COVID-19/epidemiologia , Criança , Estudos Transversais , Educação à Distância , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pais , SARS-CoV-2 , Inquéritos e Questionários , Estados Unidos , Adulto Jovem
10.
Biomed Res Int ; 2021: 5546790, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34518801

RESUMO

The spread of COVID-19 worldwide continues despite multidimensional efforts to curtail its spread and provide treatment. Efforts to contain the COVID-19 pandemic have triggered partial or full lockdowns across the globe. This paper presents a novel framework that intelligently combines machine learning models and the Internet of Things (IoT) technology specifically to combat COVID-19 in smart cities. The purpose of the study is to promote the interoperability of machine learning algorithms with IoT technology by interacting with a population and its environment to curtail the COVID-19 pandemic. Furthermore, the study also investigates and discusses some solution frameworks, which can generate, capture, store, and analyze data using machine learning algorithms. These algorithms can detect, prevent, and trace the spread of COVID-19 and provide a better understanding of the disease in smart cities. Similarly, the study outlined case studies on the application of machine learning to help fight against COVID-19 in hospitals worldwide. The framework proposed in the study is a comprehensive presentation on the major components needed to integrate the machine learning approach with other AI-based solutions. Finally, the machine learning framework presented in this study has the potential to help national healthcare systems in curtailing the COVID-19 pandemic in smart cities. In addition, the proposed framework is poised as a pointer for generating research interests that would yield outcomes capable of been integrated to form an improved framework.


Assuntos
COVID-19/epidemiologia , Controle de Doenças Transmissíveis/métodos , Aprendizado de Máquina , Algoritmos , Inteligência Artificial , COVID-19/prevenção & controle , COVID-19/transmissão , Cidades/epidemiologia , Busca de Comunicante/métodos , Atenção à Saúde , Humanos , Internet das Coisas , Pandemias , SARS-CoV-2/patogenicidade
11.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48323

RESUMO

O Ministério da Saúde irá distribuir mais de 1 milhão de coleiras impregnadas com inseticida “deltametrina 4%” para controlar a disseminação da leishmaniose visceral (LV). A pasta investiu mais de R$ 16 milhões na aquisição das coleiras como parte do processo de incorporação do insumo no controle da doença no Sistema Único de Saúde (SUS).


Assuntos
Leishmaniose Visceral/prevenção & controle , Estratégias de Saúde , Controle de Doenças Transmissíveis/métodos
12.
PLoS One ; 16(8): e0256241, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34388215

RESUMO

The importance of researching public support for preventive policies have been amplified by the COVID-19 pandemic. Using a representative sample of the Hungarian population, we investigated the support for commonly used preventive measures (social distancing, hand hygiene and wearing masks) comparing two different policy tools (nudges and regulations). Because of the high risk and unfamiliarity of the pandemic, the respondents' risk perception and experience with the disease was also assessed. All preventive measures were generally supported and, contrary to the findings of previous nudge research, there was no clear pattern whether regulations or nudges are preferred. People with higher level of risk perception supported both types of policies more but slightly favoured the regulations. Those who had contact with the disease (either themselves or a close friend or family member contracting COVID-19) reported a higher level of risk perception. When the person themselves was afflicted, this higher levels of risk perception did not translate to a higher level of support, moreover, it even decreased support for the regulations according to regression analysis. In case of a loved one contracting the disease, there was an increased support for both types of measures, but that is explained by the higher risk perception.


Assuntos
Atitude , COVID-19/psicologia , Controle de Doenças Transmissíveis/métodos , Opinião Pública , Adolescente , Adulto , COVID-19/epidemiologia , COVID-19/prevenção & controle , Feminino , Humanos , Hungria , Masculino , Pessoa de Meia-Idade , Assunção de Riscos
13.
Am J Law Med ; 47(2-3): 205-248, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34405780

RESUMO

This Article presents the first comprehensive analysis of the contribution of behavioral science to the legal response to the COVID-19 pandemic. At the descriptive level, the Article shows how different psychological phenomena such as loss aversion and cultural cognition influenced the way policymakers and the public perceived the pandemic, and how such phenomena affected the design of laws and regulations responding to COVID-19. At the normative level, the Article compares nudges (i.e., choice-preserving, behaviorally informed tools that encourage people to behave as desired) and mandates (i.e., obligations backed by sanctions that dictate to people how they must behave). The Article argues that mandates rather than nudges should serve in most cases as the primary legal tool used to regulate behavior during a pandemic. Nonetheless, this Article highlights ways in which nudges can complement mandates.


Assuntos
Ciências do Comportamento , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/métodos , Formulação de Políticas , Políticas de Controle Social/legislação & jurisprudência , Viés , Humanos , Motivação , SARS-CoV-2 , Cognição Social , Normas Sociais
14.
PLoS One ; 16(8): e0256014, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34415941

RESUMO

OBJECTIVES: Eradicated infectious diseases like smallpox can re-emerge through accident or the designs of bioterrorists, and cause heavy casualties. Presently, the populace is largely susceptible as only a small percentage is vaccinated, and their immunity is likely to have waned. And when the disease re-emerges, the susceptible individuals may be manipulated by disinformation on Social Media to refuse vaccines. Thus, a combination of countermeasures consisting of antiviral drugs and vaccines and a range of policies for their application need to be investigated. Opinions regarding whether to receive vaccines evolve over time through social exchanges via networks that overlap with but are not identical to the disease propagation networks. These couple the spread of the biological and information contagion and necessitate a joint investigation of the two. METHODS: We develop a computationally tractable metapopulation epidemiological model that captures the joint spatio-temporal evolution of an infectious disease (e.g., smallpox, COVID-19) and opinion dynamics. RESULTS: Considering smallpox, the computations based on the model show that opinion dynamics have a substantial impact on the fatality count. Towards understanding how perpetrators are likely to seed the infection, we identify a) the initial distribution of infected individuals that maximize the overall fatality count; and b) which habitation structures are more vulnerable to outbreaks. We assess the relative efficacy of different countermeasures and conclude that a combination of vaccines and drugs minimize the fatalities, and by itself, drugs reduce fatalities more than the vaccine. Accordingly, we assess the impact of increase in the supply of drugs and identify the most effective among a collection of policies for administering of drugs for various parameter combinations. Many of the observed patterns are stable to variations of a diverse set of parameters. CONCLUSIONS: Our findings provide a quantitative foundation for various important elements of public health discourse that have largely been conducted qualitatively.


Assuntos
Controle de Doenças Transmissíveis/métodos , Modelos Teóricos , Opinião Pública , Varíola/prevenção & controle , COVID-19/prevenção & controle , Vacinas contra COVID-19/uso terapêutico , Humanos , Mortalidade , Densidade Demográfica , Guerra Psicológica , Varíola/tratamento farmacológico , Varíola/epidemiologia , Varíola/transmissão , Vacina Antivariólica/uso terapêutico , Análise Espaço-Temporal , Processos Estocásticos , Recusa de Vacinação/psicologia
15.
JAMA Netw Open ; 4(8): e2119621, 2021 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-34402891

RESUMO

Importance: In 2020 and early 2021, the National Football League (NFL) and National Collegiate Athletic Association (NCAA) opted to host football games in stadiums across the country. The in-person attendance of games varied with time and from county to county. There is currently no evidence on whether limited in-person attendance of games is associated with COVID-19 case numbers on a county-level. Objective: To assess whether NFL and NCAA football games with limited in-person attendance were associated with increased COVID-19 cases in the counties they were held compared with a matched set of counties. Design, Setting, and Participants: In this time-series cross-sectional study, every county hosting NFL or NCAA games with in-person attendance (treated group) in 2020 and 2021 was matched with a county that that did not host a game on the corresponding day but had an identical game history for up to 14 days prior (control group). A standard matching method was used to further refine this matched set so that the treated and matched control counties had similar population size, nonpharmaceutical interventions in place, and COVID-19 trends. The association of hosting games with in-person attendance with COVID-19 cases was assessed using a difference-in-difference estimator. Data were analyzed from August 29 to December 28, 2020. Exposures: Hosting NFL or NCAA games. Main Outcomes and Measures: The main outcome was estimation of new COVID-19 cases per 100 000 residents at the county level reported up to 14 days after a game among counties with NFL and NCAA games with in-person attendance. Results: A total of 528 games with in-person attendance (101 NFL games [19.1%]; 427 NCAA games [80.9%]) were included. The matching algorithm returned 361 matching sets of counties. The median (interquartile range [IQR]) number of attendance for NFL games was 9949 (6000 to 13 797) people. The median number of attendance for NCAA games was not available, and attendance was recorded as a binary variable. The median (IQR) daily new COVID-19 cases in treatment group counties hosting games was 26.14 (10.77-50.25) cases per 100 000 residents on game day. The median (IQR) daily new COVID-19 cases in control group counties where no games were played was 24.11 (9.64-48.55) cases per 100 000 residents on game day. The treatment effect size ranged from -5.17 to 4.72, with a mean (SD) of 1.21 (2.67) cases per 100 000 residents, within the 14-day period in all counties hosting the games, and the daily treatment effect trend remained relatively steady during this period. Conclusions and Relevance: This cross-sectional study did not find a consistent increase in the daily COVID-19 cases per 100 000 residents in counties where NFL and NCAA games were held with limited in-person attendance. These findings suggest that NFL and NCAA football games hosted with limited in-person attendance were not associated with substantial risk for increased local COVID-19 cases.


Assuntos
COVID-19/epidemiologia , Controle de Doenças Transmissíveis/estatística & dados numéricos , Saúde da População/estatística & dados numéricos , Vigilância de Evento Sentinela , Instalações Esportivas e Recreacionais/estatística & dados numéricos , COVID-19/prevenção & controle , COVID-19/transmissão , Controle de Doenças Transmissíveis/métodos , Estudos Transversais , Futebol Americano , Humanos , Organizações sem Fins Lucrativos , SARS-CoV-2 , Sociedades , Estados Unidos/epidemiologia , Universidades
16.
Nat Commun ; 12(1): 4720, 2021 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-34354055

RESUMO

Forecasting the evolution of contagion dynamics is still an open problem to which mechanistic models only offer a partial answer. To remain mathematically or computationally tractable, these models must rely on simplifying assumptions, thereby limiting the quantitative accuracy of their predictions and the complexity of the dynamics they can model. Here, we propose a complementary approach based on deep learning where effective local mechanisms governing a dynamic on a network are learned from time series data. Our graph neural network architecture makes very few assumptions about the dynamics, and we demonstrate its accuracy using different contagion dynamics of increasing complexity. By allowing simulations on arbitrary network structures, our approach makes it possible to explore the properties of the learned dynamics beyond the training data. Finally, we illustrate the applicability of our approach using real data of the COVID-19 outbreak in Spain. Our results demonstrate how deep learning offers a new and complementary perspective to build effective models of contagion dynamics on networks.


Assuntos
COVID-19/epidemiologia , Controle de Doenças Transmissíveis/métodos , Aprendizado Profundo , Surtos de Doenças/prevenção & controle , Previsões/métodos , Humanos , Modelos Teóricos , SARS-CoV-2 , Espanha/epidemiologia
17.
Nat Commun ; 12(1): 4726, 2021 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-34354078

RESUMO

Latin America has been severely affected by the COVID-19 pandemic but estimations of rates of infections are very limited and lack the level of detail required to guide policy decisions. We implemented a COVID-19 sentinel surveillance study with 59,770 RT-PCR tests on mostly asymptomatic individuals and combine this data with administrative records on all detected cases to capture the spread and dynamics of the COVID-19 pandemic in Bogota from June 2020 to early March 2021. We describe various features of the pandemic that appear to be specific to a middle income countries. We find that, by March 2021, slightly more than half of the population in Bogota has been infected, despite only a small fraction of this population being detected. The initial buildup of immunity contributed to the containment of the pandemic in the first and second waves. We also show that the share of the population infected by March 2021 varies widely by occupation, socio-economic stratum, and location. This, in turn, has affected the dynamics of the spread with different groups being infected in the two waves.


Assuntos
COVID-19/epidemiologia , COVID-19/transmissão , COVID-19/diagnóstico , Colômbia/epidemiologia , Controle de Doenças Transmissíveis/métodos , Geografia , Humanos , SARS-CoV-2 , Estudos Soroepidemiológicos , Fatores Socioeconômicos
18.
PLoS One ; 16(8): e0255819, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34358283

RESUMO

This study explores the interplay between public measures adopted by the U.S. government to combat COVID-19 and the performance of the American hospitality industry. The recent global pandemic is a natural experiment for exploring the role of government interventions and their direct impact on hospitality stock returns in the U.S. financial market. Overall, our findings show that most of the government interventions were associated with a negative response in the returns of the hospitality industry, a response that became more negative as the COVID-19 pandemic evolved. Similar patterns were also detected for other industries such as entertainment and transportation that are closely related to hospitality. The findings we document are fundamental to understanding the trends and fluctuations in hospitality stocks in the current crisis and any similar crisis in the future.


Assuntos
COVID-19/prevenção & controle , Controle de Doenças Transmissíveis , Turismo , Viagem , Algoritmos , Controle de Doenças Transmissíveis/métodos , Governo , Humanos , Indústrias , Pandemias
19.
PLoS One ; 16(8): e0239352, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34370739

RESUMO

The U.S. with only 4% of the world's population, bears a disproportionate share of infections in the COVID-19 pandemic. To understand this puzzle, we investigate how mitigation strategies and compliance can work together (or in opposition) to reduce (or increase) the spread of COVID-19 infection. Building on the Oxford index, we create state-specific stringency indices tailored to U.S. conditions, to measure the degree of strictness of public mitigation measures. A modified time-varying SEIRD model, incorporating this Stringency Index as well as a Compliance Indicator is then estimated with daily data for a sample of 6 U.S. states: New York, New Hampshire, New Mexico, Colorado, Texas, and Arizona. We provide a simple visual policy tool to evaluate the various combinations of mitigation policies and compliance that can reduce the basic reproduction number to less than one, the acknowledged threshold in the epidemiological literature to control the pandemic. Understanding of this relationship by both the public and policy makers is key to controlling the pandemic. This tool has the potential to be used in a real-time, dynamic fashion for flexible policy options. Our methodology can be applied to other countries and has the potential to be extended to other epidemiological models as well. With this first step in attempting to quantify the factors that go into the "black box" of the transmission factor ß, we hope that our work will stimulate further research in the dual role of mitigation policies and compliance.


Assuntos
COVID-19/epidemiologia , Pessoal Administrativo , Número Básico de Reprodução/legislação & jurisprudência , Número Básico de Reprodução/prevenção & controle , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/legislação & jurisprudência , Controle de Doenças Transmissíveis/métodos , Humanos , Pandemias/legislação & jurisprudência , Pandemias/prevenção & controle , SARS-CoV-2/isolamento & purificação , Estados Unidos/epidemiologia
20.
Proc Natl Acad Sci U S A ; 118(34)2021 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-34408019

RESUMO

Understanding how populations' daily behaviors change during the COVID-19 pandemic is critical to evaluating and adapting public health interventions. Here, we use residential electricity-consumption data to unravel behavioral changes within peoples' homes in this period. Based on smart energy-meter data from 10,246 households in Singapore, we find strong positive correlations between the progression of the pandemic in the city-state and the residential electricity consumption. In particular, we find that the daily new COVID-19 cases constitute the most dominant influencing factor on the electricity demand in the early stages of the pandemic, before a lockdown. However, this influence wanes once the lockdown is implemented, signifying that residents have settled into their new lifestyles under lockdown. These observations point to a proactive response from Singaporean residents-who increasingly stayed in or performed more activities at home during the evenings, despite there being no government mandates-a finding that surprisingly extends across all demographics. Overall, our study enables policymakers to close the loop by utilizing residential electricity usage as a measure of community response during unprecedented and disruptive events, such as a pandemic.


Assuntos
COVID-19/epidemiologia , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/métodos , Comportamento Cooperativo , Equipamentos e Provisões Elétricas/estatística & dados numéricos , Eletricidade , Quarentena , COVID-19/transmissão , Características da Família , Humanos , Saúde Pública , SARS-CoV-2/isolamento & purificação , Singapura/epidemiologia
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