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1.
Emerg Infect Dis ; 27(2): 452-462, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33496221

RESUMO

Greece imposed a nationwide lockdown in March 2020 to mitigate transmission of severe acute respiratory syndrome coronavirus 2 during the first epidemic wave. We conducted a survey on age-specific social contact patterns to assess effects of physical distancing measures and used a susceptible-exposed-infectious-recovered model to simulate the epidemic. Because multiple distancing measures were implemented simultaneously, we assessed their overall effects and the contribution of each measure. Before measures were implemented, the estimated basic reproduction number (R0) was 2.38 (95% CI 2.01-2.80). During lockdown, daily contacts decreased by 86.9% and R0 decreased by 81.0% (95% credible interval [CrI] 71.8%-86.0%); each distancing measure decreased R0 by 10%-24%. By April 26, the attack rate in Greece was 0.12% (95% CrI 0.06%-0.26%), one of the lowest in Europe, and the infection fatality ratio was 1.12% (95% CrI 0.55%-2.31%). Multiple social distancing measures contained the first epidemic wave in Greece.


Assuntos
/epidemiologia , Transmissão de Doença Infecciosa/estatística & dados numéricos , Modelos Estatísticos , Quarentena/estatística & dados numéricos , Adolescente , Adulto , Idoso , /transmissão , Criança , Pré-Escolar , Transmissão de Doença Infecciosa/prevenção & controle , Feminino , Grécia/epidemiologia , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Quarentena/legislação & jurisprudência , Adulto Jovem
2.
MMWR Morb Mortal Wkly Rep ; 70(4): 109-113, 2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33507893

RESUMO

On March 19, 2020, the governor of California issued a statewide stay-at-home order to contain the spread of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19).* The order reduced accessibility to and patient attendance at outpatient medical visits,† including preventive services such as cervical cancer screening. In-person clinic visits increased when California reopened essential businesses on June 12, 2020.§ Electronic medical records of approximately 1.5 million women served by Kaiser Permanente Southern California (KPSC), a large integrated health care system, were examined to assess cervical cancer screening rates before, during, and after the stay-at-home order. KPSC policy is to screen women aged 21-29 years every 3 years with cervical cytology alone (Papanicolaou [Pap] test); those aged 30-65 years were screened every 5 years with human papillomavirus (HPV) testing and cytology (cotesting) through July 15, 2020, and after July 15, 2020, with HPV testing alone, consistent with the latest recommendations from U.S. Preventive Services Task Force.¶ Compared with the 2019 baseline, cervical cancer screening rates decreased substantially during the stay-at-home order. Among women aged 21-29 years, cervical cytology screening rates per 100 person-months declined 78%. Among women aged 30-65 years, HPV test screening rates per 100 person-months decreased 82%. After the stay-at-home order was lifted, screening rates returned to near baseline, which might have been aided by aspects of KPSC's integrated, organized screening program (e.g., reminder systems and tracking persons lost to follow-up). As the pandemic continues, groups at higher risk for developing cervical cancers and precancers should be evaluated first. Ensuring that women receive preventive services, including cancer screening and appropriate follow-up in a safe and timely manner, remains important.


Assuntos
/prevenção & controle , Prestação Integrada de Cuidados de Saúde , Detecção Precoce de Câncer/estatística & dados numéricos , Quarentena/legislação & jurisprudência , Neoplasias do Colo do Útero/prevenção & controle , Adulto , Idoso , California/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Adulto Jovem
3.
BMC Public Health ; 21(1): 225, 2021 01 27.
Artigo em Inglês | MEDLINE | ID: mdl-33504347

RESUMO

BACKGROUND: The first COVID-19 cases were diagnosed in Australia on 25 January 2020. Initial epidiemiology showed that the majority of cases were in returned travellers from overseas. One aspect of Public Health response was to introduce compulsory 14 day quarantine for all travellers returning to New South Wales (NSW) by air or sea in Special Health Accommodation (SHA). We aim to outline the establishment of a specialised health quarantine accommodation service in the context of the COVID-19 pandemic, and describe the first month of COVID-19 screening. METHODS: The SHA was established with a comprehensive governance structure, remote clinical management through Royal Prince Alfred Virtual Hospital (rpavirtual) and site management with health care workers, NSW Police and accommodation staff. RESULTS: From 29 March to 29 April 2020, 373 returning travellers were admitted to the SHA from Sydney Airport. 88 (26.1%) of those swabbed were positive for SARS-CoV 2. The day of diagnosis of COVID-19 varied from Day 1 to Day 13, with 63.6% (n = 56) of these in the first week of quarantine. 50% of the people in the SHA were referred to rpavirtual for ongoing clinical management. Seven people required admission to hospital for ongoing clinical care. CONCLUSION: The Public Health response to COVID-19 in Australia included early and increased case detection through testing, tracing of contacts of confirmed cases, social distancing and prohibition of gatherings. In addition to these measures, the introduction of mandated quarantine for travellers to Australia was integral to the successful containment of COVID-19 in NSW and Australia through the prevention of transmission locally and interstate from returning travellers.


Assuntos
/prevenção & controle , Doenças Transmissíveis Importadas/prevenção & controle , Serviços de Saúde , Saúde Pública , Quarentena/legislação & jurisprudência , Viagem/legislação & jurisprudência , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Criança , Pré-Escolar , Doenças Transmissíveis Importadas/epidemiologia , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , New South Wales/epidemiologia , Adulto Jovem
4.
Soc Sci Med ; 269: 113569, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33309154

RESUMO

We investigate the links between corruption and compliance with social distancing during COVID-19 pandemic in America. Both theory and empirical evidence point to a corrosive effect of corruption on trust/social capital which in turn determine people's behavior towards compliance with public health policies. Using data from 50 states we find that people who live in more corrupt states are less likely to comply with so called shelter in place/stay at home orders. Our results are robust to different measures of corruption.


Assuntos
/prevenção & controle , Fraude/estatística & dados numéricos , Fidelidade a Diretrizes/estatística & dados numéricos , Quarentena/legislação & jurisprudência , /epidemiologia , Guias como Assunto , Humanos , Capital Social , Confiança/psicologia , Estados Unidos/epidemiologia
5.
Medicina (Kaunas) ; 56(12)2020 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-33322462

RESUMO

Since the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, Italy has proven to be one of the countries with the highest coronavirus-linked death rate. To reduce the impact of SARS-CoV-2 coronavirus, the Italian Government decision-makers issued a series of law decrees that imposed measures limiting social contacts, stopped non-essential production activities, and restructured public health care in order to privilege assistance to patients infected with SARS-CoV-2. Health care services were substantially limited including planned hospitalization and elective surgeries. These substantial measures were criticized due to their impact on individual rights including freedom and autonomy, but were justified by the awareness that hospitals would have been unable to cope with the surge of infected people who needed treatment for COVID-19. The imbalance between the need to guarantee ordinary care and to deal with the pandemic, in a context of limited health resources, raises ethical concerns as well as clinical management issues. The emergency scenario caused by the COVID-19 pandemic, especially in the lockdown phase, led the Government and health care decision-makers to prioritize community safety above the individuals' rights. This new community-centered approach to clinical care has created tension among the practitioners and exposed health workers to malpractice claims. Reducing the morbidity and mortality rates of the COVID-19 pandemic is the priority of every government, but the legitimate question remains whether the policy that supports this measure could be less harmful for the health care system.


Assuntos
/prevenção & controle , Política de Saúde , Direitos do Paciente , Administração em Saúde Pública/ética , Quarentena/ética , /mortalidade , Emergências , Humanos , Itália/epidemiologia , Administração em Saúde Pública/legislação & jurisprudência , Quarentena/legislação & jurisprudência
7.
Euro Surveill ; 25(50)2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33334399

RESUMO

In France, measures including curfew and lockdown were implemented to control the COVID-19 pandemic second wave in 2020. This study descriptively assesses their possible effects, also relative to their timing. A considerable decrease in incidence of COVID-19 cases and hospital admissions was observed 7 to 10 days after mitigation measures were put in place, occurring earlier in metropolitan areas which had implemented these first. This temporal coincidence suggests the measures' positive impact, consistent with international experiences.


Assuntos
/prevenção & controle , Controle de Doenças Transmissíveis/métodos , Pandemias , Quarentena , População Urbana/estatística & dados numéricos , /diagnóstico , /transmissão , Cidades , Controle de Doenças Transmissíveis/estatística & dados numéricos , França/epidemiologia , Hospitalização , Humanos , Incidência , Quarentena/legislação & jurisprudência , Fatores de Tempo
8.
BMC Public Health ; 20(1): 1750, 2020 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-33225945

RESUMO

BACKGROUND: The economic, psychological, and social impact of pandemics and social distancing measures prompt the urgent need to determine the efficacy of non-pharmaceutical interventions (NPIs), especially those considered most stringent such as stay-at-home and self-isolation mandates. This study focuses specifically on the impact of stay-at-home orders, both nationally and internationally, on the control of COVID-19. METHODS: We conducted an observational analysis from April to May 2020 and included both countries and US states with known stay-at-home orders. Our primary exposure was the time between the date of the first reported case of COVID-19 to an implemented stay-at-home mandate for each region. Our primary outcomes were the time from the first reported case to the highest number of daily cases and daily deaths. We conducted linear regression analyses, controlling for the case rate of the outbreak in each respective region. RESULTS: For countries and US states, a longer period of time between the first reported case and stay-at-home mandates was associated with a longer time to reach both the peak daily case and death counts. The largest effect was among regions classified as the latest 10% to implement a mandate, which in the US, predicted an extra 35.3 days (95% CI: 18.2, 52.5) to the peak number of cases, and 38.3 days (95% CI: 23.6, 53.0) to the peak number of deaths. CONCLUSIONS: Our study supports the association between the timing of stay-at-home orders and the time to peak case and death counts for both countries and US states. Regions in which mandates were implemented late experienced a prolonged duration to reaching both peak daily case and death counts.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Saúde Global/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Quarentena/legislação & jurisprudência , Infecções por Coronavirus/mortalidade , Humanos , Pneumonia Viral/mortalidade , Fatores de Tempo , Estados Unidos/epidemiologia
9.
Int J Equity Health ; 19(1): 198, 2020 11 06.
Artigo em Inglês | MEDLINE | ID: mdl-33158449

RESUMO

While the coronavirus disease 2019 (COVID-19) pandemic is an ongoing worldwide, including South Korea (hereinafter Korea), it is impossible to predict the duration of the pandemic. To stop the spread of COVID-19, "social distancing," which included mandatory lockdown, and attention to personal hygiene are being adopted globally as non-pharmaceutical preventive strategies. In Korea, after maintaining strong social distancing rules for a while, the government transitioned to implementing "distancing in daily life" since May 6, 2020. The distancing in daily life was combined with infection prevention activities to stop the COVID-19 pandemic, while guaranteeing one's daily life and economic activities.In this regard, the Ministry of Health and Welfare in Korea disclosed key rules for personal quarantine. The five key rules for individual infection control are as follows: to stay at home for 3-4 days if you feel unwell, keep a distance of two arms' length from others, to wash your hands for 30 s and cough or sneeze into your sleeves, ventilate at least twice a day and disinfect regularly, and stay connected while physically distancing. However, for vulnerable populations, it is very difficult to follow such rules.Thus, we attempted to recommend how the society could support such vulnerable populations who may face difficulties in following these individual infection control rules. Through our recommendations for the weakest part of our society, we expect to strengthen the overall social structure.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Populações Vulneráveis , Infecções por Coronavirus/epidemiologia , Governo , Humanos , Higiene , Pneumonia Viral/epidemiologia , Quarentena/legislação & jurisprudência , República da Coreia/epidemiologia
10.
MMWR Morb Mortal Wkly Rep ; 69(45): 1691-1694, 2020 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-33180757

RESUMO

Mitigation measures, including stay-at-home orders and public mask wearing, together with routine public health interventions such as case investigation with contact tracing and immediate self-quarantine after exposure, are recommended to prevent and control the transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) (1-3). On March 11, the first COVID-19 case in Delaware was reported to the Delaware Division of Public Health (DPH). The state responded to ongoing community transmission with investigation of all identified cases (commencing March 11), issuance of statewide stay-at-home orders (March 24-June 1), a statewide public mask mandate (from April 28), and contact tracing (starting May 12). The relationship among implementation of mitigation strategies, case investigations, and contact tracing and COVID-19 incidence and associated hospitalization and mortality was examined during March-June 2020. Incidence declined by 82%, hospitalization by 88%, and mortality by 100% from late April to June 2020, as the mask mandate and contact tracing were added to case investigations and the stay-at-home order. Among 9,762 laboratory-confirmed COVID-19 cases reported during March 11-June 25, 2020, two thirds (6,527; 67%) of patients were interviewed, and 5,823 (60%) reported completing isolation. Among 2,834 contacts reported, 882 (31%) were interviewed and among these contacts, 721 (82%) reported completing quarantine. Implementation of mitigation measures, including mandated mask use coupled with public health interventions, was followed by reductions in COVID-19 incidence and associated hospitalizations and mortality. The combination of state-mandated community mitigation efforts and routine public health interventions can reduce the occurrence of new COVID-19 cases, hospitalizations, and deaths.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Saúde Pública/legislação & jurisprudência , Adolescente , Adulto , Idoso , Busca de Comunicante , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/terapia , Infecções por Coronavirus/transmissão , Delaware/epidemiologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Máscaras/estatística & dados numéricos , Pessoa de Meia-Idade , Pneumonia Viral/mortalidade , Pneumonia Viral/terapia , Pneumonia Viral/transmissão , Quarentena/legislação & jurisprudência , Adulto Jovem
11.
BMC Public Health ; 20(1): 1650, 2020 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-33148209

RESUMO

BACKGROUND: Strong evidence demonstrates that social support plays a key role in facilitating preventive health behaviors. The aim of the current study was to assess the effects of perceived social support on compliance with stay-at-home orders in response to a COVID-19 outbreak during the Persian New Year (Nowruz) holydays, since Nowruz holidays of 2020 coincided with the peak of the coronavirus epidemic in Iran. METHODS: This cross-sectional survey was carried out based on phone interviews of 1073 adults aged over 18 years from 4 to 12 April 2020 in Mashhad, Khorasan-Razavi Province, as the second largest city of Iran. A systematic random sampling was carried out using fixed phone number lists provided by Telecommunication Company of Khorasan-Razavi Province. Phone interviews were carried out by trained interviewers from the Iranian Students Polling Agency (ISPA) at various times of the day. The survey included sociodemographic questions, perceived social support scale (MSPSS) and questions about self-isolation during the Nowruz holiday. Statistical analysis included Chi-square test, Mann-Whitney test and multivariate logistic regression. RESULTS: 20.5% of participants reported poor compliance with stay at home orders during the first 2 weeks of Nowruz. Clear social gradients were not found in stay-at-home compliance. When controlling socio-demographic factors, perceived social support, interestingly, both fostered and hindered people's compliance with stay at home orders, depending on the source of support from family members (OR = .874, 95% CI = .803, .950, p < .005), friends (OR = 1.147, 95% CI = 1.076, 1.222, p < .001) and a significant other person (OR = .926, 95% CI = .849, 1.010, p = .084). CONCLUSIONS: Public health messaging may need to emphasize the role that friends and families can play in helping to protect those in their friendship/family groups by promoting compliance with social distancing. Further in-depth studies are recommended to evaluate how this kind of messaging can most effectively encourage people to engage in social distancing practices.


Assuntos
Infecções por Coronavirus/prevenção & controle , Surtos de Doenças , Fidelidade a Diretrizes/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quarentena/legislação & jurisprudência , Apoio Social , Adulto , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia
13.
Isr J Health Policy Res ; 9(1): 54, 2020 10 20.
Artigo em Inglês | MEDLINE | ID: mdl-33081833

RESUMO

BACKGROUND: The outbreak of a new Coronavirus disease (COVID-19) poses dramatic challenges to public health authorities worldwide. One measure put in place to contain the spread of the disease is self-quarantine of individuals who may have been exposed to the disease. While officials expect the public to comply with such regulation, studies suggest that a major obstacle to compliance for self-quarantine is concern over loss of income or employment due to the prolonged absence from work. METHODS: A cohort study of the adult population of Israel was conducted in two time points during the COVID-19 outbreak, the last week of February and the third week of March 2020, in order to assess public attitudes. In particular, public compliance rates to self-quarantine with and without State-sponsored compensation for lost wages were assessed. RESULTS: The results suggest that public attitudes changed as the threat increased, making people more compliant with regulations. In February 2020, compliance rate for self-quarantine dropped from 94% to less than 57% when monetary compensation for lost wages was removed; however, in March 2020 this drop became more moderate (from 96 to 71%). The multivariate logistic regression revealed that older, non-Jewish, worried over COVID-19, and trusting the Ministry of Health were more likely than their counterparts to comply with self-isolation, even when monetary compensation was not assumed. CONCLUSIONS: Despite the effects of threat on people's obedience with regulations, this study demonstrates that providing people with assurances about their livelihood during absence from work remains an important component in compliance with public health regulations.


Assuntos
Infecções por Coronavirus/prevenção & controle , Surtos de Doenças/prevenção & controle , Fidelidade a Diretrizes/estatística & dados numéricos , Renda , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Assistência Pública/estatística & dados numéricos , Quarentena/legislação & jurisprudência , Adolescente , Adulto , Idoso , Estudos de Coortes , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Adulto Jovem
17.
Public Health ; 188: 4-7, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33039678

RESUMO

BACKGROUND: Governments and health policymakers are now looking for strategies to lift the COVID-19 lockdown, while reducing risk to the public. METHODS: We propose the population attributable risk (PAR) as an established epidemiological tool that could support decision-making through quickly estimating the main benefits and costs of various exit strategies. RESULTS: We demonstrate the feasibility of use of PAR using pandemic data, that were publicly available in mid-May 2020 from Scotland and the US, to estimate the proportion of COVID-19 hospital admissions which might be avoided, and the proportion of adverse labour market effects - for various scenarios - based on maintaining the lockdown for those of certain ages with and without comorbidities. CONCLUSION: These calculations could be refined and applied in different countries to inform important COVID-19 policy decisions, using routinely collected data.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Política Pública , Medição de Risco/métodos , Adulto , Idoso , Infecções por Coronavirus/epidemiologia , Emprego/economia , Estudos de Viabilidade , Hospitalização/estatística & dados numéricos , Humanos , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Quarentena/legislação & jurisprudência , Escócia/epidemiologia , Estados Unidos/epidemiologia , Adulto Jovem
20.
Public Health ; 187: 41-52, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32898760

RESUMO

OBJECTIVES: To investigate factors associated with adherence to self-isolation and lockdown measures due to COVID-19 in the UK. STUDY DESIGN: Online cross-sectional survey. METHODS: Data were collected between 6th and 7th May 2020. A total of 2240 participants living in the UK aged 18 years or older were recruited from YouGov's online research panel. RESULTS: A total of 217 people (9.7%) reported that they or someone in their household had symptoms of COVID-19 (cough or high temperature/fever) in the last 7 days. Of these people, 75.1% had left the home in the last 24 h (defined as non-adherent). Men were more likely to be non-adherent, as were people who were less worried about COVID-19, and who perceived a smaller risk of catching COVID-19. Adherence was associated with having received help from someone outside your household. Results should be taken with caution as there was no evidence for associations when controlling for multiple analyses. Of people reporting no symptoms in the household, 24.5% had gone out shopping for non-essentials in the last week (defined as non-adherent). Factors associated with non-adherence and with a higher total number of outings in the last week included decreased perceived effectiveness of government 'lockdown' measures, decreased perceived severity of COVID-19 and decreased estimates of how many other people were following lockdown rules. Having received help was associated with better adherence. CONCLUSIONS: Adherence to self-isolation is poor. As we move into a new phase of contact tracing and self-isolation, it is essential that adherence is improved. Communications should aim to increase knowledge about actions to take when symptomatic or if you have been in contact with a possible COVID-19 case. They should also emphasise the risk of catching and spreading COVID-19 when out and about and the effectiveness of preventative measures. Using volunteer networks effectively to support people in isolation may promote adherence.


Assuntos
Infecções por Coronavirus/prevenção & controle , Fidelidade a Diretrizes/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quarentena/legislação & jurisprudência , Isolamento Social , Adolescente , Adulto , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Reino Unido/epidemiologia , Adulto Jovem
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